Cochrane · systematic review · CD015592
Positioning for lumbar puncture in newborn infants
Pessano, S, Bruschettini, M, Prescott, MGlenton, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
6
No studies
8
Included studies
NR
No studies 8 · 57.1%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 14.3%Moderate 3 · 21.4%High 1 · 7.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyLateral decubitus position compared to sitting position for lumbar puncture in newborn infants
Population: lumbar puncture in newborn infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Successful lumbar puncture procedure at the first attempt, with < 10000 red blood cells/mm3№ of participants: 1249(2 RCTs) Lateral decubitus position vs sitting position | RR 0.99 [0.88, 1.12] | NR | Moderate Downgraded: imprecision |
Total number of lumbar puncture attempts (successful or unsuccessful)—not reported Lateral decubitus position vs sitting position | no estimate extracted | NR | No studies |
Episodes of bradycardia№ of participants: 1279(3 RCTs) Lateral decubitus position vs sitting position | RR 1.72 [1.08, 2.76] | NR | Moderate Downgraded: imprecision |
Time to perform the lumbar puncture№ of participants: 1102(2 RCTs) Lateral decubitus position vs sitting position | MD 2 | NR | High |
Episodes of desaturation (decrease of SpO2 to less than 80%)№ of participants: 1249(2 RCTs) Lateral decubitus position vs sitting position | RR 2.1 [1.42, 3.08] | NR | Moderate Downgraded: imprecision |
Apnea: number of episodes (interruption of breathing for more than 20 seconds) during the procedure№ of participants: 197(2 RCTs) Lateral decubitus position vs sitting position | RR 0 | NR | Low Downgraded: risk of bias, imprecision |
Apnea: number of infants with 1 or more episodes (defined as interruption of breathing for more than 20 seconds) during the procedure—not reported Lateral decubitus position vs sitting position | no estimate extracted | NR | No studies |
Lateral decubitus position compared to prone position for lumbar puncture in newborn infants
Population: lumbar puncture in newborn infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Successful lumbar puncture procedure at the first attempt№ of participants: 171(1 RCT) Lateral decubitus position vs prone position | RR 0.75 [0.63, 0.9] | NR | Low Downgraded: risk of bias, imprecision |
Total number of lumbar puncture attempts—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Episodes of bradycardia, defined as a fall in heart rate of more than 30% below the baseline or less than 100 beats per minute for 10 seconds or longer— not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Time to perform the lumbar puncture—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Episodes of desaturation, defined as a decrease of SpO2 to less than 80%, with no minimum duration specified—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Apnea: number of episodes (defined as interruption of breathing for more than 20 seconds) during the procedure—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Apnea: number of infants with 1 or more episodes (defined as interruption of breathing for more than 20 seconds) during the procedure—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Lateral decubitus position compared to sitting position for lumbar puncture in newborn infants
Population: lumbar puncture in newborn infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Successful lumbar puncture procedure at the first attempt, with < 500 red blood cells/mm3№ of participants: 1249(2 RCTs) Lateral decubitus position vs sitting position | RR 0.93 [0.85, 1.02] | NR | Low Downgraded: imprecision, inconsistency |
Total number of lumbar puncture attempts—not reported Lateral decubitus position vs sitting position | no estimate extracted | NR | No studies |
Episodes of bradycardia№ of participants: 1279(3 RCTs) Lateral decubitus position vs sitting position | RR 1.72 [1.08, 2.76] | NR | Moderate Downgraded: imprecision |
Time to perform the lumbar puncture№ of participants: 20(1 RCT) Lateral decubitus position vs sitting position | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Episodes of desaturation (decrease of SpO2 to less than 80%)№ of participants: 1249(2 RCTs) Lateral decubitus position vs sitting position | RR 2.1 [1.42, 3.08] | NR | Moderate Downgraded: imprecision |
Apnea: number of episodes (interruption of breathing for more than 20 seconds) during the procedure№ of participants: 197(2 RCTs) Lateral decubitus position vs sitting position | RR 0 | NR | Low Downgraded: risk of bias, imprecision |
Apnea: number of infants with 1 or more episodes (defined as interruption of breathing for more than 20 seconds) during the procedure—not reported Lateral decubitus position vs sitting position | no estimate extracted | NR | No studies |
Lateral decubitus position compared to prone position for lumbar puncture in newborn infants
Population: lumbar puncture in newborn infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Successful lumbar puncture procedure at the first attempt, with < 500 red blood cells/mm3№ of participants: 171(1 RCT) Lateral decubitus position vs prone position | RR 0.75 [0.63, 0.9] | NR | Low Downgraded: risk of bias, imprecision |
Total number of lumbar puncture attempts—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Episodes of bradycardia, defined as a fall in heart rate of more than 30% below the baseline or less than 100 beats per minute for 10 seconds or longer— not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Time to perform the lumbar puncture—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Episodes of desaturation, defined as a decrease of SpO2 to less than 80%, with no minimum duration specified—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Apnea: number of episodes (defined as interruption of breathing for more than 20 seconds) during the procedure—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |
Apnea: number of infants with 1 or more episodes (defined as interruption of breathing for more than 20 seconds) during the procedure—not reported Lateral decubitus position vs prone position | no estimate extracted | NR | No studies |