Hemorrhage Elimination During Lumbar Puncture Using Ultrasound Measurements (HELPUS)
Vanderbilt University Medical Center
Summary
This is a clinical trial to determine the extent to which ultrasound-assisted lumbar puncture using a standardized procedure, including use of ultrasound to ascertain the presence of cerebrospinal fluid (CSF) at L3 - L5 and the optimal needle insertion distance, increases the acquisition rate of CSF that is interpretable for patient management.
Description
Lumbar puncture (LP) is a frequently performed procedure in pediatric emergency departments, most often to evaluate meningitis in hyperthermic, hypothermic, or ill-appearing neonates, infants and children. Older children often present with headaches, meningismus, and/or altered mental status. The risks of LP include introduction of pathogens, pain, the need for multiple attempts, and failure to obtain interpretable CSF. The latter frequently leads to a spine ultrasound study the following day and, if this does not demonstrate an epidural blood clot, repeat lumbar puncture using fluoroscopic g…
Eligibility
- Age range
- 0–1 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * \- Neonates and infants (\< 12 months) * Hemodynamically stable * Undergoing a lumbar puncture for diagnostic testing Exclusion Criteria: * \- Infants \> 12 months and 1 day * Signs of clinical instability * Known spinal anomalies (e.g., spina bifida, meningomyelocele) or previous spinal surgery
Interventions
- Deviceultrasound contrast
Ultrasound of spinal canal without contrast. We included the term "ultrasound contrast" because the choices were limited.
Location
- Vanderbilt University Medical CenterNashville, Tennessee