Long subcutaneous tunnelling reduces infection rates in paediatric external ventricular drains

Purpose The aim of this study is to report the efficacy of long subcutaneous tunnelling of external ventricular drains in reducing rates of infection and catheter displacement in a paediatric population. Methods In children requiring external ventricular drainage, a long-tunnelled drain was placed a...

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Bibliographic Details
Published in:Child's nervous system 2014-10, Vol.30 (10), p.1671-1678
Main Authors: Collins, Christian D. E., Hartley, John C., Chakraborty, Aabir, Thompson, Dominic N. P.
Format: Article
Language:English
Subjects:
Adolescent
Anti-Bacterial Agents - therapeutic use
Central Nervous System Bacterial Infections - etiology
Central Nervous System Bacterial Infections - prevention & control
Cerebrospinal Fluid Shunts - adverse effects
Child
Child, Preschool
Female
Hemorrhage - surgery
Humans
Hydrocephalus - surgery
Infant
Infant, Newborn
Infection - drug therapy
Infection - etiology
Infection - therapy
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Original Paper
Retrospective Studies
Surgical Wound Infection - etiology
Surgical Wound Infection - prevention & control
Ventriculostomy - adverse effects
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Summary:Purpose The aim of this study is to report the efficacy of long subcutaneous tunnelling of external ventricular drains in reducing rates of infection and catheter displacement in a paediatric population. Methods In children requiring external ventricular drainage, a long-tunnelled drain was placed and managed according to a locally agreed guideline. End points were novel CSF infection incurred during the time of drainage and re-operation to re-site displaced catheters. Data were compared to other published series. Results One hundred eighty-one long-tunnelled external ventricular drains (LTEVDs) were inserted. The mean age was 6.6 years (range 0–15.5 years). Reasons for insertion included intraventricular haemorrhage (47 %), infection (27 %), tumour-related hydrocephalus (7.2 %), as a temporising measure (17 %) and trauma (2.2 %). The overall new infection rate for LTEVD was 2.76 %. If the 48 cases where LTEVDs were inserted to treat an existing infection are excluded, the infection rate was 3.8 % (5/133). The mean duration of insertion was 10 days (range 0–42 days). Four LTEVDs (2.2 %) were inadvertently dislodged, requiring reinsertion. Thirteen patients required removal of EVD alone. There was a significant difference ( p  
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-014-2523-3