Static Ultrasound Left First-Attempt NICU Lumbar Puncture Success at 50%

In a single-center randomized trial of 95 lumbar punctures, static ultrasound left first-attempt nontraumatic success at 50% in both groups and added eight minutes on average. The operator signal is a training hypothesis, not a deployment verdict.

THE HOT TAKE

Ultrasound found the anatomy. It did not, by itself, improve the trial's main lumbar puncture result.

A 2026 prospective randomized trial at one tertiary NICU compared static ultrasound assistance with the traditional landmark technique in infants aged 6 months or younger who needed a lumbar puncture. Sixteen proceduralists performed 95 lumbar punctures in 91 infants: 49 landmark procedures in 47 infants and 46 ultrasound-assisted procedures in 46 infants. The primary analysis included 48 landmark procedures because the number of attempts was missing for one procedure. First-attempt nontraumatic success was exactly 50% in each group: 24/48 with landmarks and 23/46 with ultrasound (OR 1.00, 95% CI 0.41-2.43; P=1.00).