Ventriculostomy infections: The effect of monitoring duration and catheter exchange in 584 patients

Kathryn L. Holloway, Tom Barnes, Sung Choi, Ross Bullock, Lawrence F. Marshall, Howard M. Eisenberg, John A. Jane, John D. Ward, Harold F. Young, Anthony Marmarou

Research output: Contribution to journalArticle

228 Citations (Scopus)

Abstract

The investigators undertook a retrospective analysis of ventriculostomy infections to evaluate their relationship to monitoring duration and prophylactic catheter exchange. In 1984, the results of an epidemiological study of ventriculostomy-related infection were published. One of the conclusions of the paper was that the incidence of ventriculostomy-related infections rose after 5 days of monitoring. This led to the recommendation that catheters be prophylactically changed at 5-day intervals if prolonged monitoring was required. A recent randomized prospective study on central venous catheters showed no reduction in infection with prophylactic catheter exchanges. This has led the authors to reexamine their experience with ventriculostomy infections. Data on 584 severely head injured patients with ventriculostomies were prospectively collected in two data banks. The Traumatic Coma Data Bank and The Medical College of Virginia Neurocore Data Bank. These data were retrospectively analyzed for factors associated with ventriculostomy related infections. It was found that there is a relationship of ventriculitis to monitoring duration but it is not simple or linear. There is a rising risk of infection over the first 10 days, but infection then becomes very unlikely despite a population that continues to be at risk. Patients in whom catheters were replaced prior to 5 days did not have a lower infection rate than those whose catheters were exchanged at more than 5-day intervals. Based on these data, it is recommended that ventriculostomy catheters for intracranial pressure monitoring be removed as quickly as possible, and in circumstances in which prolonged monitoring is required, there appears to be no benefit from catheter exchange.

Original languageEnglish
Pages (from-to)419-424
Number of pages6
JournalJournal of Neurosurgery
Volume85
Issue number3
StatePublished - Sep 1 1996
Externally publishedYes

Fingerprint

Ventriculostomy
Catheters
Infection
Databases
Post-Head Injury Coma
Central Venous Catheters
Intracranial Pressure
Epidemiologic Studies
Head
Research Personnel
Prospective Studies

Keywords

  • duration intracranial pressure monitoring
  • head injury
  • infection
  • ventriculitis
  • ventriculostomy catheter

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Holloway, K. L., Barnes, T., Choi, S., Bullock, R., Marshall, L. F., Eisenberg, H. M., ... Marmarou, A. (1996). Ventriculostomy infections: The effect of monitoring duration and catheter exchange in 584 patients. Journal of Neurosurgery, 85(3), 419-424.

Ventriculostomy infections : The effect of monitoring duration and catheter exchange in 584 patients. / Holloway, Kathryn L.; Barnes, Tom; Choi, Sung; Bullock, Ross; Marshall, Lawrence F.; Eisenberg, Howard M.; Jane, John A.; Ward, John D.; Young, Harold F.; Marmarou, Anthony.

In: Journal of Neurosurgery, Vol. 85, No. 3, 01.09.1996, p. 419-424.

Research output: Contribution to journalArticle

Holloway, KL, Barnes, T, Choi, S, Bullock, R, Marshall, LF, Eisenberg, HM, Jane, JA, Ward, JD, Young, HF & Marmarou, A 1996, 'Ventriculostomy infections: The effect of monitoring duration and catheter exchange in 584 patients', Journal of Neurosurgery, vol. 85, no. 3, pp. 419-424.
Holloway KL, Barnes T, Choi S, Bullock R, Marshall LF, Eisenberg HM et al. Ventriculostomy infections: The effect of monitoring duration and catheter exchange in 584 patients. Journal of Neurosurgery. 1996 Sep 1;85(3):419-424.
Holloway, Kathryn L. ; Barnes, Tom ; Choi, Sung ; Bullock, Ross ; Marshall, Lawrence F. ; Eisenberg, Howard M. ; Jane, John A. ; Ward, John D. ; Young, Harold F. ; Marmarou, Anthony. / Ventriculostomy infections : The effect of monitoring duration and catheter exchange in 584 patients. In: Journal of Neurosurgery. 1996 ; Vol. 85, No. 3. pp. 419-424.
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