Does duration and sampling of external ventricular drainage systems influence infection rate?

Abstract

External ventricular drainage systems are often necessary in neurological and neurosurgical patients. The purpose of this literature review is to review the problem of external ventricular drain related infections resulting from repeated cerebrospinal fluid sampling and manipulation of the drain systems. The aim is to provide an appropriate improved protocol for care of patients undergoing external ventricular drainage treatment. Routine analysis of cerebrospinal fluid is often performed to diagnose external drainage related bacterial meningitis at an early stage. Nurses are routinely instructed to collect cerebrospinal fluid from ventricular catheters for analysis. Does the way in which sampling occurs relate to increased infection?This literature review will discuss that prophylactic frequent cerebrospinal fluid sampling is of no benefit and increases infection risk and should be limited. It will also provide evidence that duration of the external ventricular drain (EVD) systems does not correlate with infection and therefore the EVD should stay insitu for as long as clinically needed or be removed if infected.