Hypoxemia associated with lumbar puncture in neonates

Tripti Sharma, Mohit Ajmera, G. Sharma, Amrita Mayenger
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Abstract

Objectives: The objectives of the study were to study the effect of different stages of lumber puncture (LP) procedure on oxygen saturation (SpO2) in newborn baby. Materials and Methods: It was a 1-year, prospective observational study conducted in a tertiary care hospital. Forty neonates were included who fulfilled the inclusion criteria. SpO2 was measured during the different stages of LP in the recruited newborns and comparison was done between SpO2 changes in LP duration of <5 min and more than 5 min groups and the effect on SpO2 in preterm and term babies during LP. Results: Mean SpO2 during baseline, flexion, needle insertion, immediate repositioning, and 5 min after procedure were 94.5, 91.82, 88.92, 94.7, and 95.38, respectively. When compare to baseline, drop in SpO2 was found during flexion and needle insertion with p = 0.0025 and <0.0001, respectively. While comparing Mean SpO2 during different phases between duration of LP >5 min versus <5 min group, the saturation was less during flexion positioning with maximum fall at the time of needle insertion in LP duration >5 min. The regain of saturation during repositioning was more in LP <5 min versus duration >5 min group. Comparing between LP duration >5 min versus <5 min group, fall in SpO2 from baseline (5 min before LP procedure) was more in LP duration >5 min group during flexion and needle insertion phase. Hypoxemia is more in preterm than term neonates during flexion and during needle insertion, supine repositioning. Furthermore, hypoxia recovered after 5 min of supine repositioning more in term infants. Conclusions: Significant hypoxia was associated in newborn in flexion and needle insertion phase of lumbar puncture, especially in preterm newborns and those with prolonged duration of procedure.
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低氧血症与新生儿腰椎穿刺相关
目的:研究不同阶段腰椎穿刺对新生儿血氧饱和度(SpO2)的影响。材料与方法:在某三级医院进行为期1年的前瞻性观察性研究。40名符合纳入标准的新生儿被纳入。在招募的新生儿LP的不同阶段测量SpO2,并比较LP持续5分钟和5分钟时SpO2的变化。LP 5分钟组在重新定位时恢复饱和度更多。屈曲插针阶段LP持续时间>5 min与5 min组的比较。低氧血症在早产儿比足月新生儿在屈曲和针插入,仰卧位重新定位。此外,在仰卧位5分钟后,足月婴儿缺氧恢复较多。结论:新生儿在腰椎穿刺屈曲和插针阶段明显缺氧,尤其是早产儿和手术时间较长的新生儿。
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