La punción suprapúbica guiada por ecografía aumenta el rendimiento de la técnica en menores de 4 meses / Ultrasound-guided suprapubic bladder aspiration increases the success of the technique in infants less than 4 months-old

Introducción: La punción suprapúbica (PSP) es una técnica ampliamente aceptada para la obtención de muestras de orina estéril en lactantes con sospecha de infección urinaria. El control ecográfico permite mejorar su rendimiento, pero los estándares de medición han sido escasamente evaluados. Objetivo: Estudiar el rendimiento de la PSP guiada por ecografía en comparación con PSP ciega y establecer el valor de medición óptimo que garantice el éxito del procedimiento. Pacientes y métodos: Se realizó PSP guiada por ecografía a 50 lactantes ≤4 meses con sospecha de infección urinaria, determinándose el diámetro anteroposterior (DAP) y transversal de la vejiga. Se utilizaron ecógrafos Esaote MyLab® 25 Gold y Hewlett Packard Sonos® 5500, con sonda convexa de 3,5MHz. El porcentaje de éxito de la técnica y el volumen total de orina obtenido se compararon con los de un grupo control de 50 pacientes de la misma edad y características clínicas, a quienes se realizó PSP ciega. Resultados: La proporción de éxitos de la PSP ecoguiada fue del 92,3% frente al 30,8% de la PSP ciega (p<0,05), y el volumen de orina obtenido fue de 7,65±1,85ml y 6,1±2,13ml, respectivamente (p=0,001). Un DAP≥2cm resultó óptimo para garantizar el éxito de la técnica (97,8%). No se observaron complicaciones mayores en ninguno de los 2 grupos. Conclusiones: La PSP asistida con ecografía aumenta significativamente el éxito de la técnica en lactantes menores de 4 meses, siendo un DAP≥2cm el criterio óptimo para su realización (AU)

Introduction: Suprapubic bladder aspiration (SBA) is a widely accepted technique used to collect uncontaminated urine samples from infants with suspected urinary tract infection (UTI). Ultrasound-based guidance improves the success rates. The standard measurements for a successful procedure, however, have been scarcely evaluated. Objective: To assess the efficacy of ultrasound-guided SBA versus blind SBA, and to establish the bladder measurements associated with optimal results. Patients and method: Ultrasound-guided SBA was performed in 50 infants≤4 months of age with suspected UTI, and the anteroposterior (APD) and transverse diameter of the bladder were determined using ultrasound equipment (Esaote MyLab® 25 Gold, and Hewlett Packard Sonos® 5500) with a 3.5MHz convex probe. The success rates and the total volumes of collected urine were compared to a control group of 50 patients of similar age and clinical characteristics, to whom conventional blind SBA was performed. Results: The rate of successful ultrasound-guided SBA was 92.3% compared to 30.8% in the blind SBA group (P<0.05). The collected urine volumes were 7.65±1.85ml and 6.1±2.13ml, respectively (P<0.001). An APD≥2cm was associated with an optimal performance of the technique (97.8% success). No major complications were observed in either group. Conclusions: Ultrasound-guided SBA is significantly more successful than blind SBA in infants less than 4 months of age, with an APD≥2cm being optimal for conducting the procedure (AU)

[Ultrasound-guided suprapubic bladder aspiration increases the success of the technique in infants less than 4 months-old]. / La punción suprapúbica guiada por ecografía aumenta el rendimiento de la técnica en menores de 4 meses.

INTRODUCTION: Suprapubic bladder aspiration (SBA) is a widely accepted technique used to collect uncontaminated urine samples from infants with suspected urinary tract infection (UTI). Ultrasound-based guidance improves the success rates. The standard measurements for a successful procedure, however, have been scarcely evaluated. OBJECTIVE: To assess the efficacy of ultrasound-guided SBA versus blind SBA, and to establish the bladder measurements associated with optimal results. PATIENTS AND METHOD: Ultrasound-guided SBA was performed in 50 infants≤4 months of age with suspected UTI, and the anteroposterior (APD) and transverse diameter of the bladder were determined using ultrasound equipment (Esaote MyLab® 25 Gold, and Hewlett Packard Sonos® 5500) with a 3.5MHz convex probe. The success rates and the total volumes of collected urine were compared to a control group of 50 patients of similar age and clinical characteristics, to whom conventional blind SBA was performed. RESULTS: The rate of successful ultrasound-guided SBA was 92.3% compared to 30.8% in the blind SBA group (P<.05). The collected urine volumes were 7.65±1.85ml and 6.1±2.13ml, respectively (P<.001). An APD≥2cm was associated with an optimal performance of the technique (97.8% success). No major complications were observed in either group. CONCLUSIONS: Ultrasound-guided SBA is significantly more successful than blind SBA in infants less than 4 months of age, with an APD≥2cm being optimal for conducting the procedure.