Traumatic lumbar punctures in diagnostic and intrathecal treatment punctures of pediatric hemato-oncology patients

Autor:	Harri Sievänen, Päivi Lähteenmäki, Juho Kari, Sanna Halonen, Hanna Soukka, Vesa Eskola, Sauli Palmu
Přispěvatelé:	Tampere University, BioMediTech, Clinical Medicine, Department of Paediatrics
Rok vydání:	2022
Předmět:	Lipopolysaccharides Oncology Pediatrics Perinatology and Child Health Humans Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma 3121 Internal medicine Child Spinal Puncture Injections Spinal Retrospective Studies
Zdroj:	Pediatric hematology and oncology. 39(8)
ISSN:	1521-0669
Popis:	Successful first diagnostic lumbar puncture (LP) is crucial because intrathecal chemotherapy has not yet protected the central nervous system against cancer cells. If blood contaminates the cerebrospinal fluid (CSF) with blasts, they may enter the central neural system and compromise the patient’s health. We retrospectively determined the incidence of traumatic lumbar punctures (TLP) in 2,507 LPs of 250 pediatric hemato-oncology patients aged from one to 18 years, including both diagnostic and intrathecal treatment procedures, and 2,617 LPs of 1,525 other age-matched pediatric patients. We used ≥10 erythrocytes/µL in the CSF sample as the criterion of TLP. TLPs were less frequent in hemato-oncology patients than in other patients (31.6% vs. 48.5%, p < 0.0001). The incidence of TLP was significantly lower in the first diagnostic LP than in subsequent intrathecal treatment LPs (20.5% vs. 31.6%, p = 0.0046). According to logistic regression analysis, the odds of TLP was 1.6-fold if the LP procedure was not performed in the hemato-oncology department. The odds of the patient’s next LP being traumatic were threefold if the previous first LP was traumatic. A week or less time between the first and next LP tripled the odds of TLP as well. The patient’s age category was not significantly associated with the incidence of TLP. Given the risks of TLP, hemato-oncology patients’ first diagnostic LP should include administration of chemotherapy, as generally recommended, and be performed under general anesthesia or deep sedation by an experienced physician to optimize not only the success of the first LP procedure but also following procedures. publishedVersion
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::20c3d5d14755f02c1ccc3779f402e67c https://pubmed.ncbi.nlm.nih.gov/35465834 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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