Safety of lumbar puncture in patients with hemophilia.

STUDY OBJECTIVE: To determine the safety of lumbar puncture in patients with hemophilia who are pretreated with clotting factor. DESIGN: Retrospective analysis of medical records between 1980 and 1990. SETTING: Three hospitals, each serving as a regional hemophilia center. PARTICIPANTS: Thirty-three patients with hemophilia A or B who received one or more lumbar puncture. INTERVENTION: All patients received replacement of deficient factor before the lumbar puncture. Serious post-lumbar puncture complications were defined as motor or sensory deficits, incontinence, or documented intraspinal hemorrhage. RESULTS: Thirty-three patients with hemophilia A or B received a total of 52 lumbar punctures during the study period. Thirty of 33 patients (91%) had severe baseline factor deficiency, two (6%) had moderate deficiency, and one (3%) had mild deficiency. There were no serious complications reported as a result of the lumbar puncture. The 95% confidence interval for the risk of a serious complication was 0% to 5.8%. CONCLUSION: With adequate factor replacement, a lumbar puncture can be done safely in patients with hemophilia.

Hemophiliac patients in surgery. Implications for perioperative nurses.

The introduction of plasma clotting factor concentrates has changed the treatment of patients with clotting factor deficiencies dramatically. They have enabled hemophiliacs to be independent and have some control over the management of their disease as informed participants. This has played a role in shortening the number of hospitalizations that hemophiliacs may have to endure and to decrease the length of stay when they are admitted. Additionally, staff who care for these patients do not need to be afraid of the disease if they are aware of the disease process and the therapy available for its amelioration.