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Bedside ultrasound improves the success rate of lumbar puncture in infants
  1. Rebecca A Dalrymple
  1. Correspondence to Dr Rebecca A Dalrymple, Department of Nephrology, Royal Hospital for Children, Glasgow G51 4TF, UK; rebecca.dicks{at}

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Study design

Prospective, single-centre, non-blinded randomised controlled trial. Randomised using block randomisation sequence with random sized blocks

Study question

Patients: Infants aged 0 to 6 months attending when a sonographer was available. Those with spinal cord abnormalities or who are non-English speaking were excluded.

Intervention: Ultrasound (US)-guided marking of the intervertebral space and midline, compared with no marking. The US technique was taught to three individuals. The clinician performing the procedure was decided prior to randomisation.

Primary outcome: First lumbar puncture attempt successful with cerebrospinal fluid (CSF) and <1000 mm3 red blood cells.

Secondary: Success within three attempts.

Follow-up period: Nil after result obtained

Main results

One hundred and twenty-eight patients were enrolled, median age 26 days. US marking improved the success rate for the first and subsequent lumbar puncture attempts. There was no difference in the clinicians’ experience between the …

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  • Contributors RD wrote the abstract and commentary and designed the visual abstract.

  • Provenance and peer review Not commissioned; internally peer reviewed.