Analysis of the frequency and etiology of traumatic lumbar punctures in a neonatal intensive care unit in Turkiye and documentation of microorganisms

Aim: In neonatal clinics and intensive care units, lumbar puncture (LP) is often used to diagnose neurological, infectious, and metabolic disorders.The aim of our study was to determine the rate of LP traumatization and associated anthropometric variables, as well as to compare concurrent microbiological outcomes for traumatic and non-traumatic LP procedures.Materials and Methods: We performed a retrospective analysis of electronic records of neonates who underwent LP over eight years in the level three neonatal intensive care unit (NICU) of a teaching hospital in Turkey.We classified a CSF material as traumatizing lumbar puncture (TLP) when the red blood cell (RBC) count exceeded 500 cells/mm 3 and classified the rest as non-traumatizing lumbar puncture (nTLP).Results: During the study period, 854 newborn infants underwent LP procedures and 325 (38.06%) had TLP.There was no significant difference between the TLP and nTLP groups in terms of birth weight, birth weight percentile, gestational week, and year of procedure.As postnatal age increased, the TLP rate decreased in both term and preterm patients (p = 0.001).When the rates of laboratory evaluation of CSF samples were compared, the rate of sending the sample to the laboratory was significantly lower in the TLP group compared to the nTLP group (p<0.05).Discussion: The TLP rate in our center is consistent with the rates found in the literature.Our findings suggest that the likelihood of TLP decreases with increasing age of the newborn.Further studies with ancillary methods such as superficial ultrasonographic imaging are needed to decrease the rate of TLP.