Pandit, Anand S;
Palasz, Joanna;
Nachev, Parashkev;
Toma, Ahmed K;
(2022)
Mechanical Complications of External Ventricular and Lumbar Drains.
World Neurosurgery
, 166
e140-e154.
10.1016/j.wneu.2022.06.127.
Preview |
Text
1-s2.0-S1878875022009123-main.pdf - Accepted Version Download (4MB) | Preview |
Abstract
BACKGROUND: External ventricular drain (EVD) and lumbar drain insertion are two of the most commonly performed neurosurgical procedures worldwide for acute hydrocephalus. Mechanical complications, such as obstruction or CSF leakage are often seen and may contribute toward significant patient morbidity. Different CSF drainage methods are advocated to reduce the incidence of complications, but evidence regarding comparative effectiveness is limited. METHODS: In this single-centre prospective cohort study, the incidence of mechanical complications and associated interventional factors, including choice of drain, collecting system and location were studied in patients requiring CSF diversion for acute hydrocephalus. Univariate analyses were performed to explore trends within the data, followed by a repeated-measures, mixed-effects regression to determine the independent influence of drain device on mechanical failure. RESULTS: 61 patients required CSF diversion between January 2020 to March 2021, via 3 different drain types (lumbar drain, tunnelled and bolted EVD) and 2 collection systems (LiquoGuard ® 7 and Becker®), performed in either theatre or intensive care. 21(39%) patients experienced a mechanical complication with blockage being the most common. Multivariate analyses demonstrated that bolted EVDs (Odds Ratio, 0.08; Confidence Interval, 0.01-0.58) and LiquoGuards (OR,0.23; CI,0.08-0.69) were significantly associated with a less mechanical complications as compared to tunnelled EVDs and Becker systems respectively (p≤0.01). DISCUSSION: Drain device has an influence on the occurrence of EVD-related complications. These preliminary findings suggest that choosing bolted EVDs and motor-assisted drainage can reduce drain-associated mechanical failure. A randomised controlled trial comparing drain devices is now required to confirm these findings.
Archive Staff Only
 |
View Item |
