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Ventriculostomy and Infection: A 4-year-review in a local hospital.

Tse Ts, Cheng K, Wong K, Pang K, Wong C - Surg Neurol Int (2010)

Bottom Line: Retrospective review of all cases involving ventriculostomy in one centre of a 4-year-period (Pamela Youde Nethersole Eastern Hospital, a local regional hospital in Hong Kong). 336 cases of admission involving 328 patients with a total of 368 ventriculostomy performed in the centre in a 4-year-period.Main outcome measures include Rate of infection and risk factors related to infections. 10 cases of out 336 cases (2.98%) of ventriculostomy were complicated by infection.Neither the duration of ventriculostomy, revision, urokinase instillation or haemorrhage showed significance in the rate of ventriculostomy-related infection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR.

ABSTRACT

Background: To review the complication rate of ventriculostomy-related infection in a local regional hospital, to identify risk factors of infections and suggest measures to prevent infections.

Methods: Retrospective review of all cases involving ventriculostomy in one centre of a 4-year-period (Pamela Youde Nethersole Eastern Hospital, a local regional hospital in Hong Kong). 336 cases of admission involving 328 patients with a total of 368 ventriculostomy performed in the centre in a 4-year-period. Main outcome measures include Rate of infection and risk factors related to infections.

Results: 10 cases of out 336 cases (2.98%) of ventriculostomy were complicated by infection. Neither the duration of ventriculostomy, revision, urokinase instillation or haemorrhage showed significance in the rate of ventriculostomy-related infection. The low infection rate is compatible with other international literatures that used strict infection control measures.

Conclusion: Strict measures for prevention aid in achieving a low complication rate of ventriculostomy related infection.

No MeSH data available.


Related in: MedlinePlus

Manipulation of ventriclostomy
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Figure 0007: Manipulation of ventriclostomy

Mentions: During the period in which the external ventricular drain was inserted, a number of cases involved manipulation of the external system. Such manipulations were performed under aseptic technique and only performed if clinically indicated. However, the data collected in this study only involved 3 types of manipulations (urokinase instillation, amikicin irrigation and frequent CSF sampling). Urokinase instillation via the ventriculostomy was performed for patients with intraventricular haemorrhage (IVH) after aneurismal rupture and arteriovenous malformation were ruled out by CT cerebral angiogram or Digital subtraction cerebral arteriogram.[10] Amikicin irrigation were used in patients with central nervous system (CNS) infections which include pre-existing meningitis, post traumatic and post-operative CNS infections in the presence of positive bacterial culture in CSF via a ventriculostomy in situ.[15] CSF sampling were performed in cases with fever, raised serum white cell count, impaired mental status, duration of EVD longer than 5 days and manipulations which involved exposing the closed sterile external collection system for drained CSF. Frequent CSF sampling, which we defined as repeated CSF sampling of once every 2 to 3 days for more than 3 occasions, only involved patients with pre-existing meningitis or suspected post operative CNS infections of which frequent CSF sampling via the ventriculostomy was performed to monitor the response to treatment of the respective conditions. The table and graph represents the number of patients with urokinase instillation, amikicin irrigation and frequent sampling of CSF (without any of the 2 former procedures involved). [Figure 7, Table 5].


Ventriculostomy and Infection: A 4-year-review in a local hospital.

Tse Ts, Cheng K, Wong K, Pang K, Wong C - Surg Neurol Int (2010)

Manipulation of ventriclostomy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2958322&req=5

Figure 0007: Manipulation of ventriclostomy
Mentions: During the period in which the external ventricular drain was inserted, a number of cases involved manipulation of the external system. Such manipulations were performed under aseptic technique and only performed if clinically indicated. However, the data collected in this study only involved 3 types of manipulations (urokinase instillation, amikicin irrigation and frequent CSF sampling). Urokinase instillation via the ventriculostomy was performed for patients with intraventricular haemorrhage (IVH) after aneurismal rupture and arteriovenous malformation were ruled out by CT cerebral angiogram or Digital subtraction cerebral arteriogram.[10] Amikicin irrigation were used in patients with central nervous system (CNS) infections which include pre-existing meningitis, post traumatic and post-operative CNS infections in the presence of positive bacterial culture in CSF via a ventriculostomy in situ.[15] CSF sampling were performed in cases with fever, raised serum white cell count, impaired mental status, duration of EVD longer than 5 days and manipulations which involved exposing the closed sterile external collection system for drained CSF. Frequent CSF sampling, which we defined as repeated CSF sampling of once every 2 to 3 days for more than 3 occasions, only involved patients with pre-existing meningitis or suspected post operative CNS infections of which frequent CSF sampling via the ventriculostomy was performed to monitor the response to treatment of the respective conditions. The table and graph represents the number of patients with urokinase instillation, amikicin irrigation and frequent sampling of CSF (without any of the 2 former procedures involved). [Figure 7, Table 5].

Bottom Line: Retrospective review of all cases involving ventriculostomy in one centre of a 4-year-period (Pamela Youde Nethersole Eastern Hospital, a local regional hospital in Hong Kong). 336 cases of admission involving 328 patients with a total of 368 ventriculostomy performed in the centre in a 4-year-period.Main outcome measures include Rate of infection and risk factors related to infections. 10 cases of out 336 cases (2.98%) of ventriculostomy were complicated by infection.Neither the duration of ventriculostomy, revision, urokinase instillation or haemorrhage showed significance in the rate of ventriculostomy-related infection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR.

ABSTRACT

Background: To review the complication rate of ventriculostomy-related infection in a local regional hospital, to identify risk factors of infections and suggest measures to prevent infections.

Methods: Retrospective review of all cases involving ventriculostomy in one centre of a 4-year-period (Pamela Youde Nethersole Eastern Hospital, a local regional hospital in Hong Kong). 336 cases of admission involving 328 patients with a total of 368 ventriculostomy performed in the centre in a 4-year-period. Main outcome measures include Rate of infection and risk factors related to infections.

Results: 10 cases of out 336 cases (2.98%) of ventriculostomy were complicated by infection. Neither the duration of ventriculostomy, revision, urokinase instillation or haemorrhage showed significance in the rate of ventriculostomy-related infection. The low infection rate is compatible with other international literatures that used strict infection control measures.

Conclusion: Strict measures for prevention aid in achieving a low complication rate of ventriculostomy related infection.

No MeSH data available.


Related in: MedlinePlus