Guidelines from the United States of America and United Kingdom recommend performing an LP in cases of suspected sepsis and meningitis in neonates and infants ( 3, 4). The clinical suspicion of meningitis is greater in the presence of seizures, fever, bulging fontanel and abnormal consciousness, but in neonatal age the initial signs are often subtle, particularly in younger infants ( 2). The gold standard for the diagnosis of bacterial meningitis is a positive cerebrospinal fluid (CSF) culture, usually obtained through a lumbar puncture (LP) ( 1). These data are useful to clinicians, providing information on the safety of the procedure. Body weight or GA at LP did not affect LP failure. Failure of LP occurred in 38.2% of cases and was not associated with any of the factors evaluated.Ĭonclusions: LP was safe in most infants. No further adverse events were registered. Two infants had intraventricular hemorrhage detected within 72 h of LP. Transient, self-resolving bradycardia occurred in 7 (3.4%) infants. At multivariate analysis, lower GA at LP ( p < 0.001), non-invasive respiratory support ( p 0.007) and mechanical ventilation ( p 0.004) were associated with SpO 2 desaturations. SpO 2 desaturations occurred during 45 (22.4%) LPs. Results: Among 204 LPs, 134 were performed in full-term and 70 in pre-term born infants. Logistic regression analysis was used to evaluate whether corrected gestational age (GA), body weight at LP, position, and any respiratory support during LP affected SpO 2 desaturation or failure of LP. LP failed if cerebrospinal spinal fluid was not collected or had traces of blood. Need for resuscitation oxygen desaturation (SpO 2 < 90%), bradycardia and intraventricular hemorrhage were considered adverse events. Methods: This two-center prospective observational study investigated infants younger than 90 days of age who underwent LP. Objective: This study aims to evaluate safety and success rates of lumbar puncture (LP) and to identify factors associated with adverse events or failure of LP in infants. 6Unit of Statistics, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.

5Neonatal Intensive Care Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy.4Pediatric Post-graduate School, University Hospital of Modena and Reggio Emilia, Modena, Italy.3Pediatrics, Women's, and Children's Health Department, University Hospital of Modena, Modena, Italy.2Neonatal Intensive Care Unit, Women's and Children's Health Department, University Hospital of Modena, Modena, Italy.1PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Roversi 2, Roberto D'Amico 6, Lorenzo Iughetti 3,4 and Alberto Berardi 2,4 Luca Bedetti 1,2,3 *, Licia Lugli 2, Lucia Marrozzini 4, Alessandro Baraldi 4, Federica Leone 4, Lorenza Baroni 5, Laura Lucaccioni 3, Cecilia Rossi 2, Maria F.

Lumbar puncture position