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Intraventricular Drug Delivery and Sampling for Pharmacokinetics and Pharmacodynamics Study

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Needleless Sampling and Medication Delivery: A Painless Innovation During CSF Irrigation.

Saif Salman¹, Anna K Peterson², Wendy J Peterson³

¹Saif Salman, MD, iPostdoctoral Research Fellow, Departments of Neurologic Surgery, Neurology, and Critical Care Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Jacksonville, FL.

The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses

|January 6, 2026

Summary

This summary is machine-generated.

A new needleless extension maintains the sterility of the IRRAflow system, a closed cerebrospinal fluid (CSF) exchange device. This approach safely allows CSF sampling and medication delivery during treatment for strokes and infections.

Keywords:

Central Nervous System Infections Cerebrospinal Fluid Shunts Critical Care Nursing Ventriculostomy

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Area of Science:

Neurosurgery
Medical Devices
Infectious Disease Management

Background:

IRRAflow is a novel closed system for active cerebrospinal fluid (CSF) exchange.
It is used to treat hemorrhagic strokes and intracranial infections, delivering medications at up to 180 mL/h.
Accessing the closed system for CSF sampling or medication infusion can disrupt sterility.

Purpose of the Study:

To report a novel needleless extension technique for maintaining sterility.
To assess the compatibility and safety of this technique with the IRRAflow system.

Main Methods:

A needleless extension, including a stopcock with a 3-way valve and needleless connectors, was used in 5 patients.
The extension was connected to the IRRAflow catheter's irrigation and drainage ports.
Sterile techniques were employed for CSF sampling and medication delivery.

Main Results:

The needleless extension enabled efficient fluid exchange, CSF sampling, and medication delivery.
The system remained sterile, preventing secondary infections despite repeated interventions.
The needleless extension proved compatible with the IRRAflow device.

Conclusions:

The needleless extension provides a simple, safe method for interacting with the closed IRRAflow system.
Sterility is maintained during CSF sampling and medication delivery.
This technique enhances the management of patients requiring CSF exchange therapy.