Real‐time detection of cerebrospinal fluid with bioimpedance needle in paediatric lumbar puncture

Sievänen, Harri; Kari, Juho; Halonen, Sanna; Elomaa, Timo; Tammela, Outi; Soukka, Hanna; Eskola, Vesa

doi:10.1111/cpf.12697

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…If so, the initial contact between the needle lumen and CSF may vanish and explain the false CSF alarms, which took place in 9% of all study procedures. This value compares well with 11% and 19% incidences observed in previous clinical feasibility studies of the system 22 , 23 . Of the procedures completed with the system, the CSF detection sensitivity was 86%, being fully in line with the previously reported 82% in neonates and infants 23 and 100% in adults 22 .…”

Section: Discussionsupporting

confidence: 89%

“…This value compares well with 11% and 19% incidences observed in previous clinical feasibility studies of the system 22 , 23 . Of the procedures completed with the system, the CSF detection sensitivity was 86%, being fully in line with the previously reported 82% in neonates and infants 23 and 100% in adults 22 .…”

Section: Discussionsupporting

confidence: 89%

“…Thus, a needle guidance method that does not require specific expertise and simultaneous operation of the imaging equipment but provides real-time feedback on the needle tip location might be an option worth considering. Recently, a novel bioimpedance-based spinal needle system was found clinically feasible in LPs of both adults and infants, including neonates 22 , 23 . This new system provides real-time needle guidance by informing the user when the needle tip reaches CSF in the subarachnoid space of the spinal canal, and the correct location for CSF sampling or administration of intrathecal treatment.…”

Section: Introductionmentioning

confidence: 99%

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Bioimpedance spinal needle provides high success and low complication rate in lumbar punctures of pediatric patients with acute lymphoblastic leukemia

Långström

Huurre

Kari³

et al. 2022

Sci Rep

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In this prospective single-arm study of 50 pediatric patients with acute lymphoblastic leukemia (ALL), we evaluated the clinical performance of a novel bioimpedance spinal needle system in 152 intrathecal treatment lumbar punctures (LP) of these patients. The system detects in real-time when the needle tip reaches the cerebrospinal fluid (CSF) in the spinal canal. The success was defined as getting a CSF sample and/or administering the intrathecal treatment with one needle insertion. Incidence of traumatic LP (TLP) was defined as ≥ 10 erythrocytes/µL of CSF. Post-procedural complications were monitored with a one-week diary and one-month register follow-up. The success of the first attempt was 79.5%, with the CSF detection sensitivity of 86.1%. The incidence of TLP was 17.3%. A successful first attempt was associated with a significantly lower incidence of TLP (10% vs 40%, p = 0.0015). During the week after the procedure, the incidence of post-dural puncture headache was 6%. During the follow-up, no major complications were observed. In conclusion, the novel bioimpedance spinal needle system achieved a high success rate and low incidence of TLP and other complications in pediatric patients with ALL in a real-world clinical setting, indicating clinical utility for this system in pediatric hemato-oncology.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bioimpedance spinal needle provides high success and low complication rate in lumbar punctures of pediatric patients with acute lymphoblastic leukemia

Långström

Huurre

Kari³

et al. 2022

Sci Rep

Self Cite

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“…Lumbar puncture is a surgical procedure used primarily to sample cerebrospinal fluid (CSF) or to inject medications, including anesthetics [1][2][3]. Post-dural puncture headache (PDPH) is one of the most common complications observed in patients undergoing lumbar puncture and is usually accompanied by photophobia, nausea, neck stiffness, and subjective hearing symptoms [4].…”

Section: Introductionmentioning

confidence: 99%

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

et al. 2023

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Background: Post-dural puncture headache (PDPH) is one of the most common complications in patients undergoing spinal anesthesia. The present systematic review and meta-analysis aimed to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH.Methods: Relevant studies were identified by searching the following electronic databases, without language restriction, until June 2020: Scopus, EMBASE, MEDLINE, Google Scholar, Web of Science, Cochrane Library-CENTRAL, and CINAHL Complete. Random effects models were used to calculate the standardized mean difference (SMD) and risk ratios (RRs) with 95% confidence intervals (95% CI) to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH, respectively. The Cochrane tool was used for the quality assessment of the included studies. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation method.Results: Of the 1,349 initial records, 15 met our eligibility criteria (6 studies on therapeutic and 9 on prophylactic effects). A significant reduction in the pain score was observed following aminophylline/theophylline treatment (SMD = –1.67; 95% CI, –2.28 to –1.05; P < 0.001, I2 = 84.7%; P < 0.001). Subgroup analysis revealed that the therapeutic effect was significantly higher when these agents were compared to placebo than when conventional therapies were used. The risk of PDPH after aminophylline administration was not significantly reduced (RR = 0.74; 95% CI, 0.42 to 1.31; P = 0.290).Conclusions: Theophylline and aminophylline have therapeutic, but not prophylactic, effects on PDPH.

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“…Lumbar puncture is an invasive technique mainly performed for sampling Cerebrospinal Fluid (CSF) or injecting medications such as anesthetics (1)(2)(3). Post-dural Puncture Headache (PDPH) is prevalent among individuals undergoing lumbar puncture (4,5).…”

Section: Introductionmentioning

confidence: 99%

Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol

et al. 2021

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Objectives: Post-dural Puncture Headache (PDPH) is prevalent among individuals undergoing lumbar punctures. The non-invasive effect of some drugs, such as aminophylline on PDPH has been investigated in several clinical studies. As there is no comprehensive systematic review and meta-analysis about the preventive and therapeutic effects of aminophylline on PDPH in the literature, the clinical effectiveness of this drug on the prevention and/or treatment of PDPH will be assessed in this study. Methods: PubMed/MEDLINE, Embase, WoS (Clarivate Analytics), the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL Complete, Scopus, and Google Scholar as electronic databases will be precisely searched for clinical studies that assessed the effect of aminophylline on PDPH. Studies between 01-01-1980 and 30-06-2020 will be evaluated in this study, and there will not be any language restrictions. Contradictions between the reviewers within any phase of the study (screening, selecting, quality assessment, and data extraction) will be resolved by consensus; in case of unsolved disagreements, a third reviewer will eventually decide. The combination method will be applied according to the methodological resemblance in the selected articles using the Random Effect Model or the Fixed Effect Model. Also, for the included articles, forest plots will be drawn. For assessing statistical heterogeneity, the I2 statistic and the Q-statistic test will be applied. In addition, funnel plots will be used for assessing non-significant study effects and potential reporting bias. Furthermore, Egger’s and Begg’s tests will be done, and publication bias will be indicated by significant findings (P < 0.05). Conclusions: It is expected that the results of this study will be of benefit to researchers and clinicians for managing PDPH, and will be reported in conferences and publications.

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Real‐time detection of cerebrospinal fluid with bioimpedance needle in paediatric lumbar puncture

Cited by 11 publications

References 25 publications

Bioimpedance spinal needle provides high success and low complication rate in lumbar punctures of pediatric patients with acute lymphoblastic leukemia

Bioimpedance spinal needle provides high success and low complication rate in lumbar punctures of pediatric patients with acute lymphoblastic leukemia

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol

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