Variability of Infant LP Insertion Site Based On Procedural Experience
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 110
- 试验地点
- 1
- 主要终点
- Proportion of Trainee & Attending LP Insertion Sites that are the same
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- — 至 12 Months（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Less than or equal to 12 months of age
- •Availability of a study sonographer to perform bedside ultrasound
排除标准
- •Prior history of LP in preceding 72 hours
- •Known spinal cord abnormality (i.e., tethered cord, spina bifida)
- •Clinically unstable patients (acuity level 1)
研究组 & 干预措施
Infant Lumbar Punctures
Infants will all be assigned to received two sets of skin markings and sonography exam to assess lumbar puncture landmarks and anatomy.
干预措施: Spinal Sonography (Other)
结局指标
主要结局
Proportion of Trainee & Attending LP Insertion Sites that are the same
时间窗: 18 months
Plan to visualize marked spaces with US to delineate if the trainee and attending marked the same or different interspace (we will quanity the proportion of same interspaces marked and for those that are different, we will quantify the proportion above or below the attending marking)
次要结局
- Subarachnoid Space Area(18 months)
- Subarachnoid Space Width(18 months)
研究者
Rebecca Vieira
MD
Boston Children's Hospital