Related Experiment Videos
Comparison of rates of infection of two methods of emergency ventricular drainage
Abstract:
The rates of infection of two methods of external ventricular drainage in use at Atkinson Morley's Hospital--namely, (a) percutaneous drainage with Rickham reservoirs and (b) tunnelled ventriculostomies--were compared in this retrospective review. Percutaneous drainage of CSF with Rickham reservoirs was associated with a 27% rate of infection as identified by positive microbiological cultures; tunnelled ventriculostomy catheters had a 10% infection rate. The difference in the infection rate between the two methods was statistically significant (P < 0.015). Other variables examined, including the age and sex of the patients and the reasons for ventricular drainage, were not associated with an increased rate of infection. Most infections from either method were caused by a coagulase negative staphylococcus. The average duration of ventricular drainage before identification of positive cultures was 5.7 days for Rickham reservoirs and 6.0 days for ventriculostomies.
Insights
Tunnelled ventriculostomies show a significantly lower infection rate (10%) compared to percutaneous drainage with Rickham reservoirs (27%). This finding is crucial for reducing external ventricular drainage infections.
Area of Science:
- Neurosurgery
- Infectious Disease
Background:
- External ventricular drainage (EVD) is essential for managing intracranial pressure.
- Infection is a significant complication of EVD, necessitating comparative studies of different techniques.
Purpose of the Study:
- To compare the infection rates of two EVD methods: percutaneous drainage with Rickham reservoirs and tunnelled ventriculostomies.
- To identify risk factors associated with EVD infections.
Main Methods:
- Retrospective review of patients undergoing EVD at Atkinson Morley's Hospital.
- Comparison of infection rates between percutaneous drainage with Rickham reservoirs and tunnelled ventriculostomies.
- Microbiological cultures used to identify infections.
Main Results:
- Percutaneous drainage with Rickham reservoirs had a 27% infection rate.
- Tunnelled ventriculostomies had a 10% infection rate.
- The difference in infection rates was statistically significant (P < 0.015). Coagulase-negative staphylococcus was the most common pathogen.
Conclusions:
- Tunnelled ventriculostomies are associated with a significantly lower risk of infection compared to percutaneous drainage with Rickham reservoirs.
- Patient age, sex, and reason for drainage did not influence infection rates.
- Minimizing the duration of EVD may help reduce infection risk.