Journal article
Reducing sedated lumbar punctures in pediatric patients with acute lymphoblastic leukemia
Pediatric blood & cancer, Vol.68(11), pp.e29272-n/a
11/2021
DOI: 10.1002/pbc.29272
PMID: 34331510
Abstract
Background
Sedation for lumbar punctures (LPs) in pediatric acute lymphoblastic leukemia (ALL) patients has been the standard for decades to reduce pain and anxiety. Recent studies on the potential long‐term neurocognitive effects of cumulative propofol exposure have raised concerns about this practice. The recent pandemic introduced additional burdens to patients, with the requirement of a negative COVID‐19 test prior to each sedated procedure.
Procedure
These factors prompted a quality improvement intervention at our institution where we aimed to reduce postinduction sedated LPs by 50%. Our intervention included patient and family education, followed by a simulation of the procedure for selected patients. Those converted to unsedated LPs were queried for their preference. Comparative cost, clinical time, and LP success rates were collected for sedated and unsedated LPs.
Results
Following the intervention, the percentage of LPs performed with sedation dropped from 100% to 48%. All LPs were successful using both techniques. Most patients who experienced the unsedated LP technique, and their guardians, strongly preferred this approach. Unsedated LPs significantly reduced clinical time (169 vs. 83 minutes) for families, decreased expenditures ($5736 reduction per procedure), and improved institutional opportunity cost due to a decrease in last‐minute cancelations.
Conclusion
We have shown that it is feasible to significantly reduce the use of sedation for LPs in patients with ALL, which has the potential to improve health and patient experience at a lower cost.
Details
- Title: Subtitle
- Reducing sedated lumbar punctures in pediatric patients with acute lymphoblastic leukemia
- Creators
- Torin W. Waters - University of Iowa Hospitals and ClinicsDavid S. Dickens - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Pediatric blood & cancer, Vol.68(11), pp.e29272-n/a
- DOI
- 10.1002/pbc.29272
- PMID
- 34331510
- ISSN
- 1545-5009
- eISSN
- 1545-5017
- Number of pages
- 7
- Language
- English
- Date published
- 11/2021
- Academic Unit
- Stead Family Department of Pediatrics; Hematology/Oncology
- Record Identifier
- 9984354041402771
Metrics
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