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Evidence-Based Management of External Ventricular Drains
David Y Chung1,2, DaiWai M Olson3, Sayona John4
1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA. dychung@mgh.harvard.edu.
Current Neurology and Neuroscience Reports
|November 28, 2019
Summary
Optimal management of external ventricular drains (EVDs) for acute brain injury lacks clear evidence. Current research shows conflicting results and a gap between practice and existing data, necessitating further studies.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Neurology
Background:
- External ventricular drains (EVDs) are crucial for managing acute brain injury.
- Optimal EVD management strategies remain debated among clinicians.
Purpose of the Study:
- To review current evidence on optimal external ventricular drain management in acute brain injury.
- To identify evidence-based approaches for EVD management.
Main Methods:
- Literature review of recent retrospective and prospective studies.
- Analysis of multicenter surveys on EVD management practices.
- Consideration of findings from recent clinical trials (e.g., CLEAR trials).
Main Results:
- Conflicting results exist from studies on EVD management after subarachnoid hemorrhage.
- A significant discordance between clinical trial evidence and actual practice was observed.
- Recent trials suggest potential benefits of specific EVD positioning for intraventricular hemorrhage clearance.
Conclusions:
- Evidence regarding optimal external ventricular drain management is limited.
- Further multicenter prospective studies are essential to guide clinical practice.
- Standardized approaches to EVD management are needed.
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