Managment of external ventricular drainage in Intensive Care Units
Practical guide
Keywords:
DRAINAGE, BRAIN VENTRICLES, VENTRICULOSTOMY, INTENSIVE THERAPY UNITSAbstract
Intracraneal catheters, especially external ventricular drainage, are frequently used in patients with serious neurological injuries in Intensive Care Units. The management of these patients should be standarized in order to reach better results, considering the increase of risk infections at the Central Nervous System, especially after neurosurgery. Guidelines of management were established reviewing literature and considering discussions between Intensive Medicine and Neurosurgery Departments of the Faculty of Medicine. Indications, techniques, description of cerebro-spinal fluid divertion and drainage, and managment were categorized. Diagnosis of Central Nervous System infections after surgery, such as meningitis and ventriculitis were determined.
References
(1) National nosocomial infections surveillance (NNIS). System report, data summary form January 1990 - May 1999, issued June 1999. AJIC 1999; 27: 520-32.
(2) Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery 2002; 51: 170-82.
(3) Mayhall CG, Archer NH, Lamb VA, Spadora AC, Baggett JW, Ward JD, et al. Ventriculostomy-related infections. A prospective epidemiological study. N Engl J Med 1984; 310: 553-9.
(4) Albornoz H. Infecciones postoperatorias en neurocirugía. In: Correa H, Rivero J, eds. Sepsis. Tratamiento intensivo de las infecciones graves. Montevideo: Oficina del Libro FEFMUR, 2003: 191-209.
(5) Korinek AM, Golmard JL, Elcheick A, Bismuth R, Effenterre R van, Coriat P, et al. Risk factors for neurosurgical site infections after craniotomy: a critical reappraisal of antibiotic prophylaxis on 4578 patients. Br J Neurosurgery 2005; 19(2): 155-62.
(6) Woodward S, Addison C, Shab S, Brennan F, MacLeod A, Clements M. Benchmarking best practice for external ventricular drainage. Br J Nursing 2002; 11: 47-53.
(7) Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy. The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis. Br J Neurosurg 2000; 14(1): 7-12.
(8) Korinek AM, Reina M, Boch AL, Rivera AO, De Bels D, Puybasset L. Prevention of external ventricular drain-related ventriculitis. Acta Neurochir (Wien) 2005; 147: 39-46.
(9) O’Leary ST, Kole MK, Hoover DA, Hysell SE, Thomas A, Shaffrey CI. Efficacy of the Ghajar Guide revisited: a prospective study. J Neurosurg 2000; 92(5): 801-3.
(10) Khanna RK, Rosenblum ML, Rock JP, Malik GM. Prolonged external ventricular drainage with percutanous long-tunnel ventriculostomies. J Neurosurg 1995; 83: 791-4.
(11) Holloway KL, Barnes T, Choi S, Bullock R, Marshall LF, Eisenberg HM, et al. Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. J Neurosurg 1996; 85: 419-24.
(12) Hader WJ, Steinbok P. The value of routine cultures of the cerebrospinal fluid in patients with external ventriculr drains. Neurosurgery 2000; 46: 1149-53.
(13) Schade RP, Schinkel J, Roelandse FW, Geskus RB, Visser LG, Van Dijk MC, et al. Lack of value of routine analysis of cerebrospinal fluid for prediction and diagnosis of external drainage-related bacterial meningitis. J Neurosurg 2006; 104: 101-8.
(14) Leib SL, Boscacci R, Gratzl O, Zimmerli W. Predictive value of cerebrospinal fluid (CSF) lactate level versus CSF/blood glucose ratio for the diagnosis of bacterial meningitis following neurosurgery. Clin Infect Dis 1999; 29: 69-74.
(2) Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery 2002; 51: 170-82.
(3) Mayhall CG, Archer NH, Lamb VA, Spadora AC, Baggett JW, Ward JD, et al. Ventriculostomy-related infections. A prospective epidemiological study. N Engl J Med 1984; 310: 553-9.
(4) Albornoz H. Infecciones postoperatorias en neurocirugía. In: Correa H, Rivero J, eds. Sepsis. Tratamiento intensivo de las infecciones graves. Montevideo: Oficina del Libro FEFMUR, 2003: 191-209.
(5) Korinek AM, Golmard JL, Elcheick A, Bismuth R, Effenterre R van, Coriat P, et al. Risk factors for neurosurgical site infections after craniotomy: a critical reappraisal of antibiotic prophylaxis on 4578 patients. Br J Neurosurgery 2005; 19(2): 155-62.
(6) Woodward S, Addison C, Shab S, Brennan F, MacLeod A, Clements M. Benchmarking best practice for external ventricular drainage. Br J Nursing 2002; 11: 47-53.
(7) Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy. The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis. Br J Neurosurg 2000; 14(1): 7-12.
(8) Korinek AM, Reina M, Boch AL, Rivera AO, De Bels D, Puybasset L. Prevention of external ventricular drain-related ventriculitis. Acta Neurochir (Wien) 2005; 147: 39-46.
(9) O’Leary ST, Kole MK, Hoover DA, Hysell SE, Thomas A, Shaffrey CI. Efficacy of the Ghajar Guide revisited: a prospective study. J Neurosurg 2000; 92(5): 801-3.
(10) Khanna RK, Rosenblum ML, Rock JP, Malik GM. Prolonged external ventricular drainage with percutanous long-tunnel ventriculostomies. J Neurosurg 1995; 83: 791-4.
(11) Holloway KL, Barnes T, Choi S, Bullock R, Marshall LF, Eisenberg HM, et al. Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. J Neurosurg 1996; 85: 419-24.
(12) Hader WJ, Steinbok P. The value of routine cultures of the cerebrospinal fluid in patients with external ventriculr drains. Neurosurgery 2000; 46: 1149-53.
(13) Schade RP, Schinkel J, Roelandse FW, Geskus RB, Visser LG, Van Dijk MC, et al. Lack of value of routine analysis of cerebrospinal fluid for prediction and diagnosis of external drainage-related bacterial meningitis. J Neurosurg 2006; 104: 101-8.
(14) Leib SL, Boscacci R, Gratzl O, Zimmerli W. Predictive value of cerebrospinal fluid (CSF) lactate level versus CSF/blood glucose ratio for the diagnosis of bacterial meningitis following neurosurgery. Clin Infect Dis 1999; 29: 69-74.
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Published
2007-03-31
How to Cite
1.
Grille P, Costa G, Biestro A, Wajskopf S. Managment of external ventricular drainage in Intensive Care Units: Practical guide. Rev. Méd. Urug. [Internet]. 2007 Mar. 31 [cited 2024 Nov. 21];23(1):50-5. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/635
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