Superior Outcomes With Ommaya Reservoir in Sustained Intracranial Hypertension Control

Area of Science:

• Neurosurgery
• Intensive Care Medicine
• Neurology

Background:

• Persistent intracranial hypertension (ICH) is a common challenge in neuro-intensive care units (ICUs).
• Management strategies for ICH vary widely and are often based on physician experience.
• This study evaluated interventions for non-traumatic persistent ICH.

Purpose of the Study:

• To assess the efficacy of different intervention measures in treating non-traumatic persistent ICH.
• To compare the effectiveness of various methods for controlling intracranial pressure (ICP).
• To identify the optimal intervention for managing persistent ICH.

Main Methods:

• Retrospective review of 119 non-traumatic ICH cases treated in a neuro-ICU.
• Patients were categorized into five groups based on ICP control methods.
• Data analyzed included ICP, biochemical markers, patient status, and prognosis using generalized estimating equation (GEE) methods.

Main Results:

• External ventricular drain (EVD), lumbar drainage (LD), and Ommaya reservoir (OR) were more effective than drug therapy (DT) alone in reducing ICP.
• The Ommaya reservoir (OR) demonstrated optimal efficacy in ICP reduction.
• OR and lumbar puncture (LP) improved patient status (decreased mRS scores) and showed reduced renal burden and electrolyte imbalances.
• LD and EVD groups had a higher incidence of pulmonary infections.

Conclusions:

• The Ommaya reservoir is a safe and effective method for controlling ICP.
• Ommaya reservoir has significant potential for treating non-traumatic persistent ICH.
• This intervention offers advantages in patient recovery and reduced complications.