Variability of Infant LP Insertion Site Based On Procedural Experience

Completed · Not applicable

Conditions studied: Traumatic Lumbar Puncture

In brief

The reported rate of unsuccessful traditional LP in children (defined as the inability to obtain cerebrospinal fluid or obtaining a traumatic puncture) is as high as 50%. Many factors affect LP success including provider experience. CSF is obtained by puncturing the subarachnoid space (traditionally at the L3-L4 or L4-L5 interspinous process space), and many have hypothesized that the width of this space may predict success. Anecdotally, trainees and those with less experience, tend to perform the LP too low (caudally), where the subarachnoid space tapers, or too laterally (off the midline) resulting in higher failure rates. The investigators seek to determine if planned LP insertion sites vary between training and attendings, and if so, could the decreased success be explained by smaller subarachnoid spaces.

Key facts

Study ID

NCT02949869

Run by

Boston Children's Hospital

People needed

110

Starts

2016-11-01

Expected to finish

2018-08-01

Last updated by the study team

2018-11-01

Who can join

Age: any, up to 1. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Less than or equal to 12 months of age
• Availability of a study sonographer to perform bedside ultrasound

You may not qualify if…

• Prior history of LP in preceding 72 hours
• Known spinal cord abnormality (i.e., tethered cord, spina bifida)
• Clinically unstable patients (acuity level 1)

Where it is running

• Boston Children's Hospital — Boston, Massachusetts, United States

Full record on ClinicalTrials.gov

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