医学
脑室造瘘术
脑室炎
开颅术
室外引流
导管
脑室出血
蛛网膜下腔出血
随机对照试验
脑脊液
外科
脑脊液漏
回顾性队列研究
重症监护医学
脑积水
内科学
胎龄
怀孕
生物
遗传学
作者
Alan P. Lozier,Robert R. Sciacca,Mario Romagnoli,E. Sander Connolly
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2002-07-01
卷期号:51 (1): 170-182
被引量:526
标识
DOI:10.1097/00006123-200207000-00024
摘要
To provide a critical evaluation of the published literature describing risk factors for ventriculostomy-related infections (VRIs) and the efficacy of prophylactic catheter exchange.A MEDLINE literature search was performed, and data were extracted from studies published from 1941 through 2001.Published criteria for diagnosing VRIs are highly variable. Intraventricular hemorrhage, subarachnoid hemorrhage, cranial fracture with cerebrospinal fluid leak, craniotomy, systemic infections, and catheter irrigation all predispose patients to the development of VRIs. Extended duration of catheterization is correlated with an increasing risk of cerebrospinal fluid infections during the first 10 days of catheterization. Prophylactic catheter exchange does not modify the risk of developing later VRIs in retrospective studies.Categorizing suspected cerebrospinal fluid infections as contaminants, colonization, suspected or confirmed VRIs, or ventriculitis more accurately describes the patient's clinical condition and may indicate different management strategies. A prospective, randomized clinical trial is required to further evaluate the efficacy of prophylactic catheter exchange in limiting the incidence of VRIs during prolonged catheterization. Although prophylactic catheter exchange remains a practice option, the available data suggest that this procedure is not currently justified.
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