Newborn lumbar puncture: What you need to know

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Nguyen Thi My Linh - Neonatologist - Pediatrics - Neonatology - Vinmec Danang International General Hospital

Lumbar puncture or lumbar puncture is a technique that is performed by using a probe needle to poke the cerebrospinal fluid space in the lumbar region to collect a sample of cerebrospinal fluid for testing and to assess the pressure of the cerebrospinal fluid space. marrow. This is a basic and safe method in the diagnosis and treatment of some diseases of the central nervous system.

1. What is a neonatal lumbar puncture?

Like lumbar puncture in adults, lumbar puncture in newborns is also aimed at the same for neurological disease cases such as encephalitis, meningitis, meningoencephalitis due to etiology. other bacteria or viruses. The cerebrospinal fluid, which maintains about 150-180ml in the ventricles, subarachnoid space and cisterns, is a clear, colorless fluid. With the same amount of cerebrospinal fluid produced and absorbed throughout the day, CSF has the effect of limiting mechanical trauma to the brain, participating in nutrition and metabolism for the central nervous system.

2. Lumbar puncture is indicated in clinical cases

In the diagnosis:
Assess the pressure in the CSF compartment, the CSF circulation in the compartments; Laboratory tests (cells, biochemistry, culture for bacteria...) CSF; Contrast injection for myelogram, root capsule... In treatment:
Inject the drug into the subarachnoid space of the spinal cord; In surgical anesthesia:
Giving antibiotics, anti-cancer drugs, corticosteroids ... to treat diseases of the central nervous system. In order to monitor the results of antibiotic treatment with cases of encephalitis, bacterial meningitis.

3. Contraindications of lumbar puncture

Syndrome of increased pressure in the skull; Cases of brain tumors are confirmed; Severe cerebral edema; Injury to the cervical spinal cord; Bacterial infection in the needle puncture site; Coagulation disorders due to drugs or diseases, when platelets are reduced (<50,000/mm3); Relative contraindications in some cases of lumbar-sacral birth defects: spinal bifida, meningeal-spinal herniation.

4. Possible complications in lumbar puncture

When doing this lumbar puncture technique for children, there will be some common problems that can affect health such as:
Causes headaches, makes children cry. Vomiting a lot when changing positions. The skin in which the marrow is collected may become infected. Pain at the puncture site. In addition, there are more dangerous risks such as:
With newborns can cause a decrease in heart rate, this case needs to give the child oxygen and monitor. After puncture, a relative amount of cerebrospinal fluid is removed, which will cause a temporary change in intracranial pressure after the puncture, causing the patient to vomit, shock, and drop blood pressure. This case should be monitored to take appropriate action. When cleaning, improper care can cause infection at the puncture site, mild infection of the skin at the site, severe from which bacteria enter the cerebrospinal fluid cavity, causing severe infection of the nervous system, inflammation meningitis, can also infect the blood. May cause heavy bleeding, especially in children with clotting problems. If the child moves, struggles during the procedure, the puncture may be difficult, then the wrong blood vessel can be punctured, leading to blood clots, blood clots in the needle lumen, and the CSF cannot be obtained. . If this is the case, the doctor may have to repeat the procedure for the child.

5. Monitoring and taking care of children after lumbar puncture

Here are some things to keep in mind when taking care of your baby:
Give your child plenty of water : You can give your child juice, milk, or soups; With infants, it is possible to breastfeed to increase the amount of water and body fluids to replenish the amount of cerebrospinal fluid that is removed. Rest: Ensure quiet rest, enough time, minimize movement after lumbar puncture. Inactivity: Don't let your child move around a lot or be active. Regular cleaning: Keep clean, change bandages, disinfect daily if necessary.

6. Re-examination after lumbar puncture

You need to take the child to the hospital immediately for a timely examination by a doctor if:
The child cries incessantly without finding the cause. Children have convulsions, muscle twitches after lumbar puncture. Your child may vomit during the test or if after a few hours but it lasts longer or up to a few days, the child is still vomiting will need to see the doctor right away. Children show fatigue, loss of appetite and sleepiness. To have more knowledge about raising children properly, parents should proactively update useful medical information on the Vinmec.com website and immediately contact doctors and experts at Vinmec when needing support.