title: [Ultrasound-guided suprapubic bladder aspiration increases the success of the technique in infants less than 4 months-old].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
authors.affiliation: Servicio de Urgencias Pediátricas, Hospital Universitario Materno-Infantil de las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Božičnik
authors.forename: A
authors.initials: A
authors.lastname: Díez Recinos
authors.forename: M C
authors.initials: MC
authors.lastname: Moreno Cantó
authors.forename: S
authors.initials: S
authors.lastname: Pavlovič
authors.forename: F
authors.initials: F
authors.lastname: García-Muñoz Rodrigo
mesh_terms: D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D011677:Punctures / Q000379:methods*; D018084:Ultrasonography, Interventional; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000601:surgery*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000652:urine*