The Influence of Traumatic Lumbar Puncture (TLP) on Outcome of Pediatric Patients

Although lumbar puncture is generally safe, bleeding into the cerebrospinal fluid (CSF), may occur as a result of trauma during the procedure. As a consequence bacteria (in patients with sepsis) or leukemic cells (in patients with leukemia) circulating in blood may be introduced into the CSF as a result of TLP. Therefore paediatric preventive measures must be taken when performing diagnostic LP procedures in pediatric patients suspected of having leukaemia or bacteremia, including the use of deep sedation or general anaesthesia, collection of the initial diagnostic CSF by a very skilled practitioner, and platelets transfusion for ALL patients with thrombocytopenia and circulating leukaemic cells.