Assessment of a third neonatal lumbar puncture position by ultrasound measurement.

Abstract

Neonatal lumbar punctures (LPs) are most often performed when a baby younger than 30 days of age presents with a fever.1,2,3 The procedure can be challenging, even for experienced providers.4 The challenge is compounded when the patient is having respiratory or other issues such that they cannot tolerate a sitting or lateral decubitus position. Various methods for optimizing of the success of neonatal LPs have been proposed and studied.5,6,7 Nevertheless, failure rates range up to 40% in some studies.2,4,5 Traditionally, neonatal LPs have been performed in the lateral decubitus position or the sitting position, both of which require firm holding to maintain proper spacing of the spinous processes, a distance that is widely regarded as crucial to successful LP.