The Problem
Of the 16,000 LPs performed on infants annually, 59% are traumatic or unsuccessful
Lumbar Punctures
Physicians use testing of cerebrospinal fluid (CSF) as a diagnostic tool for various central nervous system-related illnesses such as meningitis, subarachnoid hemorrhage and hydrocephalus. The lumbar puncture (LP) is a significant procedure because it is the safest and most common method to obtain CSF.
Of the 400,000 LPs that are performed every year in the United States, 30% are traumatic or unsuccessful, many of which are attempted more than once. Traumatic LPs are defined as the bleeding that occurs when the needle unintentionally punctures a cerebrospinal ventricle, which results in CSF with higher hematocrit levels. Red blood cells in the CSF sample cause diagnostic ambiguity due to contamination, as testing is typically done via white blood cell counts. Unsuccessful LPs are defined as obtaining no CSF or yielding insignificant results.
The highest risk factors for failed LPs are young patient age and lack of physician experience. Infants at an age of three months and under are at a much higher risk for failed LPs because the lumbar region of an infant is smaller, making it difficult to collect CSF. Infants also tend to move during the procedure. These factors increase the risk of complications during the procedure, thus it must often be performed multiple times. Of the 16,000 LPs performed on infants in the United States each year, 59% are traumatic or unsuccessful. Additionally, misdiagnosis can lead to increased hospital stays and adverse effects due to delayed diagnosis. While there are current methods and adaptations, including image-guidance and the catheter-stylet removal technique, to improve the success rates of LPs, these methods have not created consistently significant outcomes.
Columbia University School of Engineering and Applied Sciences
Biomedical Engineering Senior Design
Biomedical Engineering Senior Design