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. 2017 Jan;7(1):15-23.
doi: 10.1177/1941874416663281. Epub 2016 Aug 11.

Variations in Strategies to Prevent Ventriculostomy-Related Infections: A Practice Survey

Ariane Lewis  1 , Barry M Czeisler  1 , Aaron S Lord  1
Affiliations

Variations in Strategies to Prevent Ventriculostomy-Related Infections: A Practice Survey

Ariane Lewis et al. Neurohospitalist. 2017 Jan.

Abstract

Background and purpose: The ideal strategy to prevent infections in patients with external ventricular drains (EVDs) is unclear.

Methods: We conducted a cross-sectional survey of members of the Neurocritical Care Society on infection prevention practices for patients with EVDs between April and July 2015.

Results: The survey was completed by 52 individuals (5% response rate). Catheter selection, use of prolonged prophylactic systemic antibiotics (PPSAs), cerebrospinal fluid (CSF) collection policies, location of EVD placement, and performance of routine EVD exchanges varied. Antibiotic-impregnated catheters (AICs) and conventional catheters (CCs) were used with similar frequency, but no respondents reported routine use of silver-impregnated catheters (SICs). The majority of respondents were either neutral or disagreed with the need for PPSA with all catheter types (CC: 75%, AIC: 85%, and SIC: 87%). Despite this, 55% of the respondents reported PPSAs were routinely administered to patients with EVDs at their institutions. The majority (80%) of the respondents reported CSF collection only on an as-needed basis. The EVD placement was restricted to the operating room at 27% of the respondents' institutions. Only 2 respondents (4%) reported that routine EVD exchanges were performed at their institution.

Conclusion: Practice patterns demonstrate that institutions use varying strategies to prevent ventriculostomy-related infections. Identification and further study of optimum care for these patients are essential to decrease the risk of complications and to aid development of practice standards.

Keywords: cerebrospinal fluid; external ventricular drain; ventriculitis; ventriculostomy-related infection.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The first pie graph illustrates the role of respondents by percentage. The second pie graph shows the specialties of the attending physicians.
Figure 2.
Figure 2.
Graph showing respondents’ opinions on the statement: “Prolonged prophylactic systemic antibiotics should be used after external ventricular drain placement.”
See this image and copyright information in PMC

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