Lumbar Puncture: Indications, Complications, Technique and CSF Analysis in Pediatric Patients

Alsuwailem, Mahdi Hassan; Alkhatem, Ahmed Hassan; Alshabib, Abdullah Ahmed; Aldraisi, Mohammed Hussain; Jughiman, Abdullah Khalid Al; Al-Turaifi, Mohammed Hussain; AlAli, Samirah Munther; Nujaydi, Ali Hussain Al

doi:10.21608/ejhm.2018.11392

Cited by 2 publications

(4 citation statements)

References 11 publications

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“…A GCS less than 10 was recorded in two patients, which is one of the contraindications to do an LP. 11,13 One patient presented with focal neurology (focal neurology was recorded for only 88 patients in this study) and seven patients with an asymmetrical decrease in power that are also regarded as contraindications to perform an LP. This means that in 10 (3.6%) of 267 patients, an LP was performed despite a contraindication being present.…”

Section: Discussionmentioning

confidence: 99%

“…At hospitals where CT scanners are not available, patients are referred to a different facility for CT imaging. 11 , 12 This, in turn, can delay diagnoses and treatment or influence CSF analysis if an LP is performed after antibiotic administration. Clinical signs should guide the clinician on whether a CT scan is indicated, as immediate LP is advantageous when there are no signs of a space-occupying lesion and an indication for an LP is present.…”

Section: Introductionmentioning

confidence: 99%

“…6,8,10 Lumbar punctures should only be performed after a patient has had a thorough neurological examination. 1,4,11 Moreover, it is important to exclude any possible existing contraindications, both neurological and non-neurological. Signs indicative of a cerebral mass lesion or raised intracranial pressure, also known as 'red flags', include focal neurological symptoms, altered mental status, papilledema and newonset seizures.…”

Section: Introductionmentioning

confidence: 99%

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Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

et al. 2022

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Background: Previous studies have found that indications for lumbar punctures (LPs) are managed differently, which raises the question of whether all LPs performed are clinically necessary. This study aimed to determine whether unnecessary (clinically not indicated) LPs were being performed at a district hospital in the Free State, South Africa.Method: This was a retrospective descriptive study. A list from the National Health Laboratory Service (NHLS) was used to identify all patients on whom an LP was performed in the adult emergency department of National District Hospital (NDH) in Bloemfontein, from 1 January 2018 to 30 June 2018. Data were captured on a data sheet and included demographic information, clinical signs and symptoms the patients presented with and the cerebrospinal fluid results.Results: A total of 364 patients fit the inclusion criteria. Of these patients, 97 files (26.6%) could not be found, patient gender and LP results could be retrieved from the NHLS barcodes. After reviewing the presenting symptoms and signs captured on the 267 files, the primary researcher considered 150 (56.4%) of the LPs performed to have been carried out unnecessarily. From the total population of 364 patients, 246 (67.6%) of the LP results were normal. Only 118 (32.4%) of the LPs performed showed some form of central nervous system pathology. Of the 150 LPs assessed to have been unnecessarily performed, 124 (84.0%) were normal.Conclusion: This retrospective review indicates that a high percentage of LPs that were clinically not indicated were performed at NDH during the study period.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

et al. 2022

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“…It also refers to the wide range of different disorders that LP can help to diagnose. Compared to other studies which investigated indications of LP [8][9][10], this study differs in not being conducted in an emergency room; most of the patients were admitted electively for evaluation of their symptoms of headache, peripheral or CNS complaints. Since idiopathic intracranial hypertension was the most common final diagnosis, this study is reflective of the fact that these patients were mostly women with a high index of suspicion for such a diagnosis, where LP is the only way to confirm such a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Lumbar Puncture in a Teaching Hospital: Indications, Findings, and Complications over Five Years with Adult Patients

Ba-Abbad¹,

Dahbour²,

Akileh³

et al. 2022

JMJ

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Background: Lumbar puncture (LP) is a bedside procedure used to investigate diseases of the central and peripheral nervous systems. We report the experience of a major teaching hospital in this procedure over a 5-year period. Methods: Medical records were reviewed of patients aged ≥ 13 years who underwent LP in the years 2014¬–2018. Age, gender, technique, indications, findings, complications, and final diagnosis were analyzed. Results: 195 patients, of whom 133 (68.2%) were females (aged 40.0 ±15.7) were studied. Opening pressure was measured in 104 (53.3%) patients (86, 82.7% females) showing a mean of 31.2±12.1cm, and closing pressure was measured in 54 (27.7%) patients with a mean of 16.5±5.7cm. Leukocyte and erythrocyte counts, and glucose and protein levels were measured in most patients (99.0%, 98.5%, 96.9%, and 96.9%, respectively). Bacterial culture and gram stain were performed in 28 (14.4%) and six (3.1%) patients, respectively. Cytology and oligoclonal bands were studied in 16 (8%) and 28 (14.4%) patients, respectively. Headache, peripheral neuropathy, and papilledema were the main indications found in 69 (35.4%), 41 (21.0%), and 26 (13.3%) patients, respectively. The most common final diagnoses were idiopathic intracranial hypertension, central nervous system inflammatory diseases, peripheral neuropathy, and meningoencephalitis in 68 (34.9%), 27 (13.3%), 20 (10.3%) and 16 (8.7%) patients, respectively. No major complications were recorded. Conclusions: LP is a common bedside procedure and the most common indications were intracranial pressure and inflammatory neurological disorders. It is a quite safe and useful procedure.

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Lumbar Puncture: Indications, Complications, Technique and CSF Analysis in Pediatric Patients

Cited by 2 publications

References 11 publications

Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

Lumbar Puncture in a Teaching Hospital: Indications, Findings, and Complications over Five Years with Adult Patients

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