Trial Outcomes & Findings for Ultrasound Assisted Lumbar Puncture in the Neonate (NCT NCT02918149)

NCT ID: NCT02918149

Last Updated: 2026-07-13

Results Overview

The proportion of successful first attempt LPs (defined as obtainment of CSF and non-traumatic LP) for patients in the ultrasound-assisted group compared to the traditional landmark palpation group.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

91 participants

Primary outcome timeframe

Up to 30 minutes

Results posted on

2026-07-13

Participant Flow

91 subjects were randomized and completed 95 LPs. Two infants were randomized to one traditional LP and one ultrasound LP; two infants were randomized to traditional LP twice.

Unit of analysis: Lumbar Puncture Procedures

Participant milestones

Participant milestones
Measure
Palpation Landmark Technique LP
Traditional landmark palpation technique will be used to perform LP Palpation Landmark Technique: Clinician will follow routine palpation landmark technique procedure for LP, such as identification of anatomic landmarks by palpation (i.e., superior borders of the posterior iliac crest lies in parallel with L4 spinous process). Palpation will be followed by "blind" stick of the appropriate inter-spinous process space. The study member will have 2 attempts to complete the LP. A "successful" attempt is obtaining cerebrospinal fluid.
Ultrasound-Assisted Technique LP
Bedside ultrasonography exam will be used for identification of anatomic landmarks before performing LP Ultrasound-Assisted Technique LP: Clinician will use an ultrasound-assisted technique to perform the LP. The Phillips CX50 ultrasound machine is an FDA approved device and will be used in accordance with its approved labeling. Spinal ultrasound will be performed using a linear high-frequency transducer to locate and mark the termination of the conus medullaris, the narrowing of the spinal canal, and the midline to delineate a "safe zone". The study team member will have 2 attempts to complete the LP. A "successful" attempt is obtaining cerebrospinal fluid.
Overall Study
STARTED
46 49
45 46
Overall Study
COMPLETED
46 49
45 46
Overall Study
NOT COMPLETED
0 0
0 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Age was collected at the time of each individual Lumbar Puncture Procedure.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Traditional
n=49 Lumbar Puncture Procedures
Subjects who underwent an LP using a traditional technique
Ultrasound
n=46 Lumbar Puncture Procedures
Subjects who underwent an LP using an ultrasound-assisted technique
Total
n=95 Lumbar Puncture Procedures
Total of all reporting groups
Age, Continuous
22 Days
n=49 Lumbar Puncture Procedures • Age was collected at the time of each individual Lumbar Puncture Procedure.
14 Days
n=46 Lumbar Puncture Procedures • Age was collected at the time of each individual Lumbar Puncture Procedure.
15 Days
n=95 Lumbar Puncture Procedures • Age was collected at the time of each individual Lumbar Puncture Procedure.
Sex: Female, Male
Female
20 Participants
n=47 Participants • Sex was analyzed at the participant level. Two infants contributed to both arms; therefore, arm-level counts include these infants in both groups, while the Total column reflects 91 unique infants.
20 Participants
n=46 Participants • Sex was analyzed at the participant level. Two infants contributed to both arms; therefore, arm-level counts include these infants in both groups, while the Total column reflects 91 unique infants.
40 Participants
n=91 Participants • Sex was analyzed at the participant level. Two infants contributed to both arms; therefore, arm-level counts include these infants in both groups, while the Total column reflects 91 unique infants.
Sex: Female, Male
Male
27 Participants
n=47 Participants • Sex was analyzed at the participant level. Two infants contributed to both arms; therefore, arm-level counts include these infants in both groups, while the Total column reflects 91 unique infants.
26 Participants
n=46 Participants • Sex was analyzed at the participant level. Two infants contributed to both arms; therefore, arm-level counts include these infants in both groups, while the Total column reflects 91 unique infants.
53 Participants
n=91 Participants • Sex was analyzed at the participant level. Two infants contributed to both arms; therefore, arm-level counts include these infants in both groups, while the Total column reflects 91 unique infants.
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.

PRIMARY outcome

Timeframe: Up to 30 minutes

Population: Two infants were randomized to one Traditional LP and one Ultrasound LP; two infants were randomized to Traditional LP twice. Number of attempts missing for one procedure.

The proportion of successful first attempt LPs (defined as obtainment of CSF and non-traumatic LP) for patients in the ultrasound-assisted group compared to the traditional landmark palpation group.

Outcome measures

Outcome measures
Measure
Traditional
n=48 LP procedures
Subjects who underwent an LP using a traditional technique
Ultrasound
n=46 LP procedures
Subjects who underwent an LP using an ultrasound-assisted technique
Proportion of Successful First Attempt LPs
24 Successful procedure
23 Successful procedure

SECONDARY outcome

Timeframe: Up to 30 minutes

Population: Two infants were randomized to one Traditional LP and one Ultrasound LP; two infants were randomized to Traditional LP twice.

The proportion of successful first attempt LPs (defined as obtainment of CSF and non-traumatic LP) for patients in the ultrasound-assisted group compared to the traditional landmark palpation group. Providers will have 2 attempts to complete the LP. If CSF cannot be obtained within 2 attempts, any subsequent attempt will be at the discretion of the attending neonatologist and will be performed outside this study by the care team.

Outcome measures

Outcome measures
Measure
Traditional
n=49 LP procedures
Subjects who underwent an LP using a traditional technique
Ultrasound
n=46 LP procedures
Subjects who underwent an LP using an ultrasound-assisted technique
Proportion of Overall Success of LPs Within 2 Attempts
43 Successful procedure
38 Successful procedure

SECONDARY outcome

Timeframe: Length of Hospitalization (approximately 1 month)

Population: Two infants were randomized to one Traditional LP and one Ultrasound LP; two infants were randomized to Traditional LP twice.

To determine whether bedside-ultrasound assisted LPs are associated with a decrease in the length of antibiotic exposure in patients undergoing LPs. If LP is unsuccessful, the mean length of antibiotic exposure as compared to patients with successful LPs will be compared.

Outcome measures

Outcome measures
Measure
Traditional
n=49 LP procedures
Subjects who underwent an LP using a traditional technique
Ultrasound
n=46 LP procedures
Subjects who underwent an LP using an ultrasound-assisted technique
Difference in Length of Antibiotic Exposure
8 Days
Interval 3.0 to 11.0
8 Days
Interval 3.0 to 11.3

Adverse Events

Traditional

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Ultrasound

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Jason Stoller

Children's Hospital of Philadelphia

Phone: 2155904393

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place