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Broviac ventriculostomy for long-term external ventricular drainage.
M J Chaparro1, M B Pritz, K S Yonemura
1Division of Neurological Surgery, California College of Medicine, University of California Irvine Medical Center, Orange.
Pediatric Neurosurgery
|January 1, 1991
Summary
This study details a novel closed external ventricular drainage system using a Broviac catheter for prolonged cerebrospinal fluid management. The system demonstrated low infection rates and resistance to dislodgement in pediatric patients.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Infectious Disease
Background:
- Prolonged cerebrospinal fluid (CSF) drainage is often necessary for pediatric patients with conditions like CSF leaks or shunt infections.
- Traditional external ventricular drainage (EVD) systems can be associated with risks such as infection and dislodgement.
Purpose of the Study:
- To describe and evaluate a closed external ventricular drainage system incorporating a Broviac catheter with a dacron cuff.
- To assess the safety, efficacy, and complication rates of this modified EVD system in pediatric patients.
Main Methods:
- A closed EVD system utilizing a Broviac catheter was placed in 17 pediatric patients for 19 procedures.
- Indications included CSF leak (1 patient) and shunt infection (16 patients).
- Drainage duration averaged 19 days (range: 6-47 days).
Main Results:
- The system was effective in managing CSF leaks and infections, with 13 of 16 infected patients eventually undergoing shunt placement.
- The infection attack rate was low at 2.77 per 1,000 patient-catheter days.
- Complications included ventricular catheter revision (4 cases) and system irrigation (4 cases); one secondary CSF infection occurred.
Conclusions:
- The Broviac ventriculostomy system offers a highly infection-resistant and stable option for prolonged CSF drainage in pediatric neurosurgery.
- This modified EVD system appears to reduce the risk of infection and dislodgement compared to conventional methods.