Injeq Oy, Tampere, Finland.
Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Clin Physiol Funct Imaging. 2021 Jul;41(4):303-309. doi: 10.1111/cpf.12697. Epub 2021 Mar 20.
Lumbar puncture is a common clinical procedure that can occasionally be difficult. Various needle guidance methods can facilitate performing this procedure, but at the expense of special expertise, equipment and facility. In the present study, we evaluated the clinical feasibility of a novel bioimpedance needle system regarding its ability to detect cerebrospinal fluid (CSF) in paediatric lumbar punctures.
We performed 40 lumbar puncture procedures using the bioimpedance needle system in 37 paediatric patients, aged from 0 days to 17 months, as a part of their prescribed examinations in two university hospitals. The bioimpedance needle is similar to a conventional 22G cutting-edge spinal needle with a stylet, except the needle and stylet are configured as a bipolar electrode with high spatial resolution. The system measures in real-time when the needle tip reaches the subarachnoid space containing CSF. The procedure was considered successful when the erythrocyte count was determined from the obtained CSF sample.
Subarachnoid space was verifiably reached in 28 out of 40 procedures (70%). Bioimpedance needle system detected CSF in 23 out of these 28 successful procedures (82%) while failed in 3 out of 28 procedures (11%). No adverse events were reported.
Bioimpedance spinal needle system was found clinically feasible in paediatric lumbar punctures, and it may offer an objective and simple means to detect the time point when the needle tip is in contact with the cerebrospinal fluid.
腰椎穿刺是一种常见的临床操作，但偶尔会有难度。各种针引导方法可以帮助完成这个操作，但需要特殊的专业知识、设备和设施。在本研究中，我们评估了一种新型生物阻抗针系统在儿科腰椎穿刺中检测脑脊液（CSF）的临床可行性。
我们在两家大学医院，对 37 名年龄在 0 天至 17 个月的儿科患者进行了 40 例腰椎穿刺，使用生物阻抗针系统。生物阻抗针类似于常规的 22G 带芯的切割式脊髓针，只是针和芯被配置为具有高空间分辨率的双极电极。当针尖到达含有 CSF 的蛛网膜下腔时，系统实时测量。当从获得的 CSF 样本中确定红细胞计数时，该操作被认为是成功的。
在 40 例操作中，28 例（70%）可确认针尖到达蛛网膜下腔。在这 28 例成功的操作中，生物阻抗针系统在 23 例（82%）中检测到 CSF，而在 28 例中 3 例（11%）失败。没有报告不良事件。
生物阻抗脊髓针系统在儿科腰椎穿刺中具有临床可行性，它可能提供一种客观而简单的方法来检测针尖接触脑脊液的时间点。
