Placement of External Ventricular Drains and Intracranial Pressure Monitors by Neurointensivists

Ehtisham, As’ad; Taylor, Scott; Bayless, Linda; Klein, Michael W.; Janzen, Jeff M.

doi:10.1007/s12028-008-9097-4

Cited by 70 publications

(39 citation statements)

References 25 publications

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“…In one of the study it was demonstrated that hemorrhagic CSF -as a consequence of SAH or intraventricular hemorrhage (IVH) -occurred four times more frequently with a group of infected patients compared to the non-infected group [15]. Additionally the potential effect of SAH and IVH on the infection rate was mentioned in some of the later studies [7,[16][17][18][19]. Within our study the correlation between SAH and higher incidence of infections proved to be significant.…”

Section: Discussionsupporting

confidence: 63%

Infections of external ventricular drainages

Strojnik¹,

Golc

Zakelšek

2013

Open Medicine

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Section: Discussionsupporting

confidence: 63%

Infections of external ventricular drainages

Strojnik¹,

Golc

Zakelšek

2013

Open Medicine

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“…Hemorrhage rates after EVD placement varied widely from 1% to 33%. [22][23][24] Scholz et al 25 reported a hemorrhage rate of 14.8% in patients who underwent EVD placement after endovascular coil embolization of cerebral aneurysms under anticoagulation or antiplatelet therapy. The risk of ventriculostomy-related hemorrhage is higher in patients with SAH treated with stent-assisted coiling than in those with coiling without a stent.…”

Section: -12mentioning

confidence: 99%

Safety and Efficacy of Intravenous Tirofiban as Antiplatelet Premedication for Stent-Assisted Coiling in Acutely Ruptured Intracranial Aneurysms

Kim¹,

Choi²,

Kang³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Stent-assisted coiling of intracranial aneurysms requires antiplatelet therapy, typically aspirin and clopidogrel to prevent thromboembolic complications. There is a substantial concern that tirofiban may increase the risk of hemorrhage when used as an antiplatelet premedication in ruptured intracranial aneurysms. Our aim was to evaluate the safety and efficacy of intravenous tirofiban administration, instead of oral dual antiplatelet agents, as an antiplatelet premedication for stent-assisted coiling in patients with acutely ruptured intracranial aneurysms.

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“…3,5,6,8,10,12,[15][16][17][18][19][20][21] In particular, EVD-associated infections were found in 0% to 20% of patients in previous studies (Table 1), and the risk of surgery-associated hemorrhages or EVD device malplacements are often described. 3,5,6,10,12,[15][16][17][18][19][20][21] The highest reported complication rate of 33% shows the possible understatement of the catheter-associated complication risk. 15) The question still remains why this variety of perioperative complications is found and whether iatrogenic factors influence the surgical complication rate and thus the outcome.…”

Section: Introductionmentioning

confidence: 99%

Do Iatrogenic Factors Bias the Placement of External Ventricular Catheters? -A Single Institute Experience and Review of the Literature-

Woernle

Burkhardt

Bellut

et al. 2011

Neurol. Med. Chir.(Tokyo)

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Placement of external ventricular drainage (EVD) catheters is the gold standard for managing acute hydrocephalus, but the range of complications varies in different studies. The objective of this present single institute study is to analyze iatrogenic factors, which may influence the EVD device placement and the patient's outcome. A total of 137 EVD placements in 120 patients at the University Hospital Zurich were analyzed retrospectively. Discriminative findings between the pre-and postoperative imaging were obtained and evaluated in detail with regards to the postoperative course, ventriculostomyrelated infection, and acute neurological deterioration directly related to the EVD placement. These findings were correlated to iatrogenic factors including education level of the neurosurgeon and surgical setting. Overall EVD-related complication rate was 16.1%, including infection rate of 10.2%, catheter malplacement rate of 2.2%, and hemorrhage rate of 3.6%. Although not statistically significant, catheter-associated hemorrhages and malplacements were found mostly in primary EVD surgery, with a higher complication rate associated with junior residents as the performing surgeon. In contrast, ventriculostomy-related infection was most likely present in patients with more than one EVD placement and in patients treated by more experienced physicians. Complications related to EVD are common. The rate and character of the complication depends on the education level of the surgeon.

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Placement of External Ventricular Drains and Intracranial Pressure Monitors by Neurointensivists

Cited by 70 publications

References 25 publications

Infections of external ventricular drainages

Infections of external ventricular drainages

Safety and Efficacy of Intravenous Tirofiban as Antiplatelet Premedication for Stent-Assisted Coiling in Acutely Ruptured Intracranial Aneurysms

Do Iatrogenic Factors Bias the Placement of External Ventricular Catheters? -A Single Institute Experience and Review of the Literature-

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