Flow-regulated external lumbar drain: applications and complications

Nanidis, Nikitas; Korfias, Stefanos; Sakas, Damianos E.

doi:10.1007/s00701-014-2203-9

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…When the daily CSF drainage was maintained between 200 and 300ml, patients did not show symptoms of headache with low cranial pressure. This was consistent with the control of CSF drainage of 10 ml/h by Nanidis N et al [13]. Therefore, in order to achieve the goal of reducing the WBC count of CSF more quickly, it is relatively safe and effective to maintain the average daily drainage volume at 250-300ml.…”

Section: Exploration Of Daily Csf Drainage Volumesupporting

confidence: 87%

Dynamic Curve Analysis of Indicators Related to Lumbar Cistern Drainage for Postoperative Meningitis

Lin

2021

World Neurosurgery

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Section: Exploration Of Daily Csf Drainage Volumesupporting

confidence: 87%

Dynamic Curve Analysis of Indicators Related to Lumbar Cistern Drainage for Postoperative Meningitis

Lin

2021

World Neurosurgery

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“…Unfortunately, technical issues limited its adoption [2]. Attempting to address safety and cost issues, Nanidis, et al recently published their experience with an inexpensive flow-regulated system [15]. The system was created from readily available components that were modified and assembled at the bedside.…”

Section: Discussionmentioning

confidence: 99%

“…The system was created from readily available components that were modified and assembled at the bedside. Although reportedly safer, assembly was difficult, and the system was not suitable for patients with labile intracranial pressure [15]. …”

Section: Discussionmentioning

confidence: 99%

“…An early electronic ELD system offered improved safety, but its widespread use was limited by technical issues [2, 14]. A more recently described, inexpensive, flow-regulated ELD system claimed a similar safety profile but was difficult to assemble and was not suitable for patients with increased intracranial pressure [15]. The system we trialed was easily connected and fully programmable, designed to prevent over- and under-drainage, allowed patients to remain ambulatory during treatment, required almost no oversight, and could have been used outside of the ICU setting.…”

Section: Introductionmentioning

confidence: 99%

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An Automated, Gravity-driven CSF Drainage System Decreases Complications and Lowers Costs

Lieberson

Eckermann

Meyer

et al. 2017

Cureus

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Background: FlowSafeTM (BeckerSmith Medical, Irvine, CA, USA) is a novel, robotic, external lumbar drainage (ELD) system, which was designed to control cerebrospinal fluid (CSF) drainage, reduce complications, and decrease treatment costs.Methods: Forty-seven consecutive neurosurgical patients requiring ELD were treated using the FlowSafe system.Results: In 39 of 40 patients with traumatic and surgical dural openings, potential CSF leaks were avoided. In seven patients with suspected normal pressure hydrocephalus, post-infectious ventriculomegaly, or pseudotumor cerebrum, we were able to assess the likelihood of improvement with shunting. The system, therefore, produced what we considered to be the “desired result” in 46 of 47 patients (98%). Our one treatment failure (2%) involved a patient with unrecognized hydrocephalus who, following a Chiari repair with a dural patch graft, was drained for six days. A persistent CSF leak eventually required a reoperation. Two patients (4%) described low-pressure headaches during treatment. Both responded to temporarily suspending or reducing the drainage rate. We saw no complications. Required nursing interventions were minimal. Conclusions: The FlowSafe system was safe and effective. In our experience, there were fewer complications compared to currently available ELD systems. The FlowSafe was well tolerated by our patients. The near elimination of nursing interventions should allow lumbar drainage to be delivered in less costly, non-intensive care unit settings. Larger trials will be needed.

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“…The drainage tube was removed, and the wound was sutured in 13 cases. Excessive drainage (13 cases) is not the total amount of cerebrospinal fluid drained daily, but there is no guarantee of a continuous average drainage 1 http://www.R-project.org/ volume of cerebrospinal fluid per hour (average drainage speed <10-15 ml/h) (Nanidis et al, 2014). In some periods, the drainage speed of cerebrospinal fluid is too fast, which leads to intracranial hypotension symptoms (headache, occasional nausea, and vomiting) (Manley and Dillon, 2000;Açikbaş et al, 2002).…”

Section: Overview Of Lumbar Drainagementioning

confidence: 99%

Analysis of risk factors and treatment strategies for lumbar cistern blockage after craniocerebral surgery

Zheng

Tian²,

Wang³

et al. 2023

Front. Neurosci.

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ObjectiveLumbar cistern blockage is a common complication of continuous lumbar cistern drainage. This paper analyzes the risk factors for lumbar cistern blockage drainage due to various causes and proposes a series of prevention and intervention measures to reduce blockage or improve recanalization after blockage.MethodsThe clinical data of 637 patients with various lesions who underwent lumbar cistern drainage in our hospital were retrospectively collected and analyzed. Perioperative clinical and imaging data were assessed. Variates were analyzed using univariate and multivariate logistic regression analyses.ResultsA total of 13.7% (87/637) of patients had lumbar cistern blockage. Multivariate analysis revealed that drainage time (≥7 days), CSF volume <200 (mL/d), CSF leakage, and abnormal CSF properties were predictors of lumbar cistern blockage. Reducing the probability of lumbar cistern blockage can be achieved by repeatedly flushing, increasing the drainage flow and shortening the drainage time. The recanalization rate after blockage was 67.8% (59/87). After the drainage tube was removed, no complications related to the drainage tube occurred during the 1-week follow-up.ConclusionLumbar cistern blockage is the main reason for poor drainage. Prevention or early intervention can effectively reduce the probability of blockage and achieve the purpose of drainage of cerebrospinal fluid.

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Flow-regulated external lumbar drain: applications and complications

Cited by 8 publications

References 23 publications

Dynamic Curve Analysis of Indicators Related to Lumbar Cistern Drainage for Postoperative Meningitis

Dynamic Curve Analysis of Indicators Related to Lumbar Cistern Drainage for Postoperative Meningitis

An Automated, Gravity-driven CSF Drainage System Decreases Complications and Lowers Costs

Analysis of risk factors and treatment strategies for lumbar cistern blockage after craniocerebral surgery

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