Early diagnosis of external ventricular drainage XXXX : results of a prospective study.

@entity1 @entity281 @entity1212 @entity413
OBJECTIVES: The aim of this study was to evaluate the influence of total drainage time on the risk of @entity1212 , and the predictive value of standard laboratory examinations for the diagnosis of bacteriologically recorded cerebrospinal fluid (CSF) @entity281 during external ventricular drainage. METHODS: During a three year period, all @entity1 of the neurosurgical intensive care unit (ICU), who received an external ventricular drain, were prospectivly studied. Daily CSF samples were obtained and examined for cell count, @entity413 and protein content. Bacteriological cultures were taken three times a week, and serum sepsis parameters were determined. RESULTS: 130 @entity1 received a total of 186 external ventricular drains. The ventricular catheters were in place from one to 25 days (mean 7.1 days). In 1343 days of drainage, the authors recorded 41 positive bacteriological cultures in 21 @entity1 between the first and the 22nd drainage day (mean 6.4). No significant correlation was found between drainage time and positive CSF culture. The only parameter that significantly correlated with the occurrence of a positive CSF culture was the CSF cell count (unpaired t test, p<0.05). CONCLUSIONS: Drainage time is not a significant risk factor for @entity1212 . Increasing CSF cell count should lead to the suspicion of bacteriological drainage contamination. Other standard laboratory parameters, such as peripheral leucocyte count, CSF @entity413 , CSF protein, or serum sepsis parameters, are not reliable predictors for @entity1212 .
