Related Experiment Video

Updated: Jan 21, 2026

A CFSE-based Assay to Study the Migration of Murine Skin Dendritic Cells into Draining Lymph Nodes During Infection with Mycobacterium bovis Bacille Calmette-Guérin
07:14

A CFSE-based Assay to Study the Migration of Murine Skin Dendritic Cells into Draining Lymph Nodes During Infection with Mycobacterium bovis Bacille Calmette-Guérin

Published on: October 9, 2016

12.6K

Decreasing External Ventricular Drain-Related Infection Rates with Duration-Independent, Clinically Indicated

Miki Katzir1, Jason J Lefkowitz2, Daniel Ben-Reuven2

  • 1Department of Neurosurgery, Rambam (Maimonides) Health Care Campus, Technion Israel Institute of Technology, Haifa, Israel.

World Neurosurgery
|August 6, 2019
PubMed
Abstract

Insights

Changing external ventricular drain (EVD) replacement protocols from routine to clinically indicated significantly reduced EVD-related infection rates and hospital stays. This highlights the importance of minimizing drain manipulation to prevent infections.

Area of Science:

  • Neurosurgery
  • Infectious Disease Prevention
  • Patient Safety

Background:

  • External ventricular drains (EVDs) are crucial for managing intracranial pressure but are associated with infection risks.
  • Routine replacement of EVDs every 5 days was a standard practice to mitigate infection, but its efficacy and impact on patient outcomes were questioned.

Purpose of the Study:

  • To evaluate the impact of a protocol change from routine EVD replacement to replacement only when clinically indicated on nosocomial EVD-related infection rates.
  • To assess the effect of this protocol change on patient outcomes, including hospital and intensive care unit (ICU) stay duration.

Main Methods:

  • A retrospective cohort study comparing infection rates between two groups: elective EVD replacement (Group A) and clinically indicated EVD replacement (Group B).
  • Analysis included data from 142 patients and 227 EVDs over a 5-year, 3-month period (1721 catheter days).

Main Results:

  • The EVD-related infection rate was significantly lower in the clinically indicated replacement group (0.08 infections per catheter day) compared to the routine replacement group (0.14 infections per catheter day).
  • Patients in the routine replacement group experienced longer median hospital stays (33 vs. 24 days) and neurosurgical ICU stays (30.5 vs. 17 days).
  • The need for multiple EVDs was an independent risk factor for infection, with a 4.6 times greater risk in the routine replacement group.

Conclusions:

  • Shifting to EVD replacement solely when clinically indicated is associated with reduced infection rates and improved patient outcomes.
  • Findings support the hypothesis that skin flora inoculation during drain manipulation is a critical risk factor for EVD infections.
  • Minimizing EVD manipulation and removing catheters as soon as clinically feasible are key strategies for infection prevention.
Keywords:
Acinetobacter baumanniiCerebrospinal fluidEVDExternal ventricular drainMeningitisVentriculitisVentriculostomy-related infection

More Related Videos

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage07:51

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

Published on: November 4, 2010

22.4K
Myeloid Cell Isolation from Mouse Skin and Draining Lymph Node Following Intradermal Immunization with Live Attenuated Plasmodium Sporozoites08:46

Myeloid Cell Isolation from Mouse Skin and Draining Lymph Node Following Intradermal Immunization with Live Attenuated Plasmodium Sporozoites

Published on: May 18, 2016

18.2K

Related Concept Videos

Decreased pulse rate01:14

Decreased pulse rate

Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
854
Criteria for Causality: Bradford Hill Criteria - II01:28

Criteria for Causality: Bradford Hill Criteria - II

The Bradford Hill criteria serve as guidelines for establishing causative links in epidemiological research. Beyond Strength, Consistency, Specificity, and Temporality, key criteria also include Biological Gradient, Plausibility, Coherence, Experiment, and Analogy. These principles assist scientists in assessing the likelihood of causation in complex biological contexts. Below is a summary of these concepts:
1.2K
Criteria for Causality: Bradford Hill Criteria - I01:30

Criteria for Causality: Bradford Hill Criteria - I

The Bradford Hill criteria are a group of principles that provide a framework to determine a causal relationship between a specific factor and a disease. There are nine criteria that are pivotal in assessing causality in epidemiological studies. Here's a closer look at Strength, Consistency, Specificity, and Temporality criteria with definitions and examples:
1.1K
Concentration and Rate Law03:03

Concentration and Rate Law

The rate of a reaction is affected by the concentrations of reactants. Rate laws (differential rate laws) or rate equations are mathematical expressions describing the relationship between the rate of a chemical reaction and the concentration of its reactants.
For example, in a generic reaction aA + bB ⟶ products, where a and b are stoichiometric coefficients, the rate law can be written as:
37.7K
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
439
Introduction to Test of Independence01:21

Introduction to Test of Independence

In statistics, the term independence means that one can directly obtain the probability of any event involving both variables by multiplying their individual probabilities. Tests of independence are chi-square tests involving the use of a contingency table of observed (data) values.
The test statistic for a test of independence is similar to that of a goodness-of-fit test:
2.9K