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Continuous Monitoring Reveals Minimal Physiologic Response to Cerebrospinal Fluid Drainage: A Pilot Study
Natassia T Miller1, Emerson B Nairon1, Moez M I Bashir1
1University of Texas Southwestern Medical Center, Dallas, TX, USA.
Journal of Nursing Measurement
|April 15, 2026
Summary
Continuous monitoring of intracranial pressure (ICP) during external ventricular drain (EVD) use revealed statistically significant, yet clinically minor, ICP changes after cerebrospinal fluid (CSF) drainage.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Neurology
Background:
- External ventricular drain (EVD) management and intracranial pressure (ICP) monitoring frequency lack standardized clinical guidelines.
- Significant variability exists in current clinical practices for EVD management.
Purpose of the Study:
- To investigate the dynamics of ICP in relation to cerebrospinal fluid (CSF) drainage via EVDs.
- To assess the clinical significance of ICP fluctuations during CSF drainage.
Main Methods:
- Continuous data acquisition (CDA) was employed for ICP measurement in three patients.
- ICP was monitored for 10 minutes before, during (3 minutes), and after CSF drainage.
Main Results:
- A statistically significant difference was observed in mean ICP before (13.9 mmHg) and after (14.7 mmHg) CSF drainage (p < .0001).
- ICP changes during CSF drainage were minimal, with a mean of 14.8 mmHg before and 14 mmHg after 3 minutes of drainage (p < .0001).
- CDA enabled precise identification of ICP trends over time.
Conclusions:
- While statistically significant, the ICP changes associated with CSF drainage were not clinically meaningful.
- Continuous data acquisition provides a detailed understanding of ICP fluctuations during EVD management.
