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Decrease in proven ventriculitis by reducing the frequency of cerebrospinal fluid sampling from extraventricular

Teresa A Williams1, Gavin D Leslie, Geoffrey J Dobb

  • 1Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, Nedlands, Australia. teresa.williams@uwa.edu.au

Journal of Neurosurgery
|August 2, 2011
PubMed
Summary
This summary is machine-generated.

Reducing cerebrospinal fluid (CSF) sampling frequency for extraventricular drains (EVDs) from daily to every 3 days significantly decreased ventriculitis incidence. This change in CSF sampling protocols led to fewer proven cases of ventriculitis.

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Ventriculitis, an infection associated with extraventricular drains (EVDs), elevates morbidity, mortality, and healthcare costs.
  • Routine cerebrospinal fluid (CSF) sampling from EVDs is standard practice, but optimal sampling frequency remains undetermined.

Purpose of the Study:

  • To evaluate the impact of reducing CSF sampling frequency from daily to every 3 days on the incidence of ventriculitis in intensive care unit (ICU) patients with EVDs.

Main Methods:

  • A comparative study in two tertiary hospital ICUs, analyzing prospective (2008-2009) and historical (2005-2007) patient cohorts.
  • CSF sampling frequency was changed from daily to every 3 days after staff education, with broader ventriculitis definition including suspected and proven cases.
  • Adult ICU patients without pre-existing neurological infections were included; more frequent sampling was allowed if clinically indicated.

Main Results:

  • The study included 207 patients in the daily sampling group and 176 in the every-3-days group.
  • The incidence of ventriculitis decreased from 17% to 11% overall, and proven ventriculitis dropped from 10% to 3% after reducing sampling frequency.
  • Reduced CSF sampling frequency (every 3 days) was independently associated with a lower incidence of ventriculitis (OR 0.44, p=0.02).

Conclusions:

  • Decreasing CSF sampling frequency to every 3 days is linked to a significant reduction in ventriculitis incidence.
  • The findings suggest that CSF sampling from EVDs can be safely performed every 3 days unless clinical signs of ventriculitis are present.
  • Reduced sampling frequency effectively lowered the rates of proven ventriculitis.