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Comparison of Complications in Patients Receiving Different Types of Intracranial Pressure Monitoring: A Retrospective Study in a Single Center in Switzerland.

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Bibliographic Details
Title: Comparison of Complications in Patients Receiving Different Types of Intracranial Pressure Monitoring: A Retrospective Study in a Single Center in Switzerland.
Authors: Dimitriou, J., Levivier, M., Gugliotta, M.
Publication Year: 2025
Collection: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Subject Terms: Bacterial Infections/diagnostic imaging, Bacterial Infections/etiology, Brain Injuries, Traumatic/diagnostic imaging, Traumatic/physiopathology, Traumatic/surgery, Cerebrospinal Fluid Shunts/adverse effects, Cohort Studies, Female, Humans, Intracranial Hemorrhages/etiology, Intracranial Pressure/physiology, Magnetic Resonance Imaging, Male, Monitoring, Physiologic, Postoperative Complications/diagnostic imaging, Postoperative Complications/etiology, Switzerland, Tomography Scanners, X-Ray Computed, Ventriculoperitoneal Shunt/adverse effects, Complication, External ventricular drainage, Infection, Intracranial pressure monitoring
Description: Intracranial pressure (ICP) monitoring has become "state of the art" in the management protocol for unconscious or sedated patients with intracranial pathologies; however, all current monitoring systems have significant drawbacks. We analyzed the complications of these monitoring devices as well as the risk factors for those complications. We reviewed a total of 288 patients with ICP monitoring, i.e., 173 external ventricular drainage (EVD) and/or 123 intraparenchymatous catheters (IPCs). Placement of the IPC or EVD was performed by a standardized protocol according to fixed anatomical landmarks. Infections were diagnosed from positive cerebrospinal fluid cultures, positive devices cultures, and/or fever; hemorrhages were diagnosed by postprocedure computed tomography. Sixteen patients (9.2%) with an EVD and 1 patient (0.8%) with an IPC system experienced an infection (P < 0.01). Factors associated with a greater risk for infections include subarachnoid hemorrhage (10 patients, 9.4%), intraventricular hemorrhage (7 patients, 8.6%), and concomitant catheters (6 patients, 3,5%). Mean monitoring time was 3.9 days (range 1-17 days), with the greatest incidence of infections between day 5 and 11. Intracerebral hemorrhage was seen in 2 patients with EVD and in 1 patient with IPC (P < 0.01). None of these patients needed surgical evacuation of the blood clot. EVD is an indispensable device in neurosurgery. Unfortunately, it has a significantly high complication rate, mostly in relation to infections. Therefore, the indication of the device used to monitor ICP must be evaluated carefully. The antimicrobial-impregnated external catheter and silver-coated catheters might decrease the problem of infection.
Document Type: article in journal/newspaper
Language: English
ISSN: 1878-8769
Relation: World Neurosurgery; https://iris.unil.ch/handle/iris/168308; serval:BIB_7393EA115E9C; 000376448700085
DOI: 10.1016/j.wneu.2015.11.037
Availability: https://iris.unil.ch/handle/iris/168308
https://doi.org/10.1016/j.wneu.2015.11.037
Accession Number: edsbas.454F0D74
Database: BASE
Description
Abstract:Intracranial pressure (ICP) monitoring has become "state of the art" in the management protocol for unconscious or sedated patients with intracranial pathologies; however, all current monitoring systems have significant drawbacks. We analyzed the complications of these monitoring devices as well as the risk factors for those complications. We reviewed a total of 288 patients with ICP monitoring, i.e., 173 external ventricular drainage (EVD) and/or 123 intraparenchymatous catheters (IPCs). Placement of the IPC or EVD was performed by a standardized protocol according to fixed anatomical landmarks. Infections were diagnosed from positive cerebrospinal fluid cultures, positive devices cultures, and/or fever; hemorrhages were diagnosed by postprocedure computed tomography. Sixteen patients (9.2%) with an EVD and 1 patient (0.8%) with an IPC system experienced an infection (P < 0.01). Factors associated with a greater risk for infections include subarachnoid hemorrhage (10 patients, 9.4%), intraventricular hemorrhage (7 patients, 8.6%), and concomitant catheters (6 patients, 3,5%). Mean monitoring time was 3.9 days (range 1-17 days), with the greatest incidence of infections between day 5 and 11. Intracerebral hemorrhage was seen in 2 patients with EVD and in 1 patient with IPC (P < 0.01). None of these patients needed surgical evacuation of the blood clot. EVD is an indispensable device in neurosurgery. Unfortunately, it has a significantly high complication rate, mostly in relation to infections. Therefore, the indication of the device used to monitor ICP must be evaluated carefully. The antimicrobial-impregnated external catheter and silver-coated catheters might decrease the problem of infection.
ISSN:18788769
DOI:10.1016/j.wneu.2015.11.037