Small versus Large Catheters for Ventriculostomy in the Management of Intraventricular Hemorrhage

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• 作者：Vianney Gilard¹ ; Ben Ousmanou Djoubairou² ; Arnaud Lepetit⁴ ; Thomas Metayer² ; Clement Gakuba⁴ ; ⁵ ; Charlotte Gourio³ ; Stephane Derey¹ ; Franç ; ois Proust⁶ ; Evelyne Emery² ; ⁵ ; Thomas Gaberel² ; ⁵ ; ^{thomas.gaberel@hotmail.fr}
• 关键词：Bacterial meningitis ; Catheter obstruction ; External ventricular drain ; Intracerebral hemorrhage ; Intraventricular hemorrhage ; Ventriculostomy
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：117-122
• 全文大小：2222 K
• 卷排序：97

文摘

Intraventricular hemorrhage (IVH) often requires the insertion of an external ventricular drain (EVD), but blood clots could occlude the catheters. Large EVD catheters may help to reduce the risk of catheter occlusion. Here, we compared small catheters with large catheters for ventriculostomy in patients suffering from IVH.MethodsWe conducted a retrospective cohort study. Patients were included if they had IVH requiring EVD insertion. We then compared baseline characteristics and outcomes of patients treated with large catheters with patients treated with small catheters.ResultsBetween 2011 and 2015, 227 IVH patients were admitted to our 2 hospitals. Among the patients, 28 were treated in first intention with large catheters, and 46 controls were identified. Insertion of large catheter decreased the risk of temporary and permanent catheter occlusion without impact on the occurrence of intracerebral hemorrhage (ICH) related to catheter insertion. There was 38.5% more catheter-related infections in the small catheter group when compared with the large catheter group, but this result was not significant. There was no impact on functional outcomes. Surprisingly, the rate of death was higher in the large catheter group.ConclusionsIn patients suffering from IVH, the use of large catheters for EVD reduced the risk of catheter occlusion without increasing the risk of ICH related to catheter insertion. The risk of catheter-related infection may subsequently be decreased by using large catheters. A prospective randomized trial would be necessary to seek out any benefits that large catheters may provide for the risk of death and functional outcome.