Ommaya reservoir infections: A 16-year retrospective analysis

Mead, Peter A.; Safdieh, Joseph E.; Nizza, P.; Tuma, S R; Sepkowitz, Kent A.

doi:10.1016/j.jinf.2013.11.014

Cited by 51 publications

(53 citation statements)

References 16 publications

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“…There have been few publications that have reviewed infection rates when accessing a shunt or reservoir in the published literature [4,5,[16][17][18][19] . Of the studies performed, there is conflicting data regarding the introduction of infection when tapping a shunt or VAD with infection rates ranging from 0 to 21.8% [4,5,[16][17][18][19] .…”

Section: Discussionmentioning

confidence: 99%

“…Of the studies performed, there is conflicting data regarding the introduction of infection when tapping a shunt or VAD with infection rates ranging from 0 to 21.8% [4,5,[16][17][18][19] . At the Children's Orthopedic Hospital Seattle, Dinndorf and Bleyer [16] reported a low risk of infection with repeated tapping of VADs for delivery of intraventricular chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Survey of Techniques Utilized to Access Ventricular Shunts and Reservoirs

et al. 2017

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Aims: This study assessed variations in pediatric neurosurgical technique when accessing shunts and ventricular access devices (VADs). Methods: A 12-question survey was developed and sent to members of the American Association of Neurological Surgeons (AANS) whose self-identified subspecialty was pediatric neurosurgery. Results: Four hundred and twenty surveys were sent out, and149 responses were received (35.5% response rate); 95.3% of respondents always use sterile gloves, 55.0% never use a sterile gown, and 69.8% always have a member of the neurosurgery team perform the procedure. The majority of respondents answered “sometimes” for use of a facemask (38.3%), sterile drapes (39.6%), site shaving (45.6%), having an attending present (68.5%), and having an assistant hold the patient's head (78.5%). The majority reported using a 23- or 25-gauge butterfly needle for site entry (96.6%), and betadine or ChloraPrep™ as the preferred antiseptic solution (64.4%). The frequency in which CSF is sent for analysis is not standardized in 31.5% of respondents, and wait time for the antiseptic solution to dry is not standardized in 62.4%. Conclusions: There is great variation in the technique for accessing shunts and VADs. Future studies are needed to assess whether these discrepancies affect infection rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Survey of Techniques Utilized to Access Ventricular Shunts and Reservoirs

et al. 2017

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“…Circumventing the BBB with local drug delivery increases the amount of drug at the target site, reducing systemic exposure and the risk of systemic toxicity. Clinical methods administer drugs by intracerebroventricular or intracortical infusion through a catheter (the Ommaya reservoir; Mead et al, 2014). These routes are fraught with issues, as fluid injection into the small ventricular spaces increases intracranial pressure and has been associated with hemorrhage, leakage of cerebrospinal fluid (CSF), and infection (Misra et al, 2003;Mead et al, 2014).…”

Section: Types Of Biomaterials Used In the Brainmentioning

confidence: 99%

“…Clinical methods administer drugs by intracerebroventricular or intracortical infusion through a catheter (the Ommaya reservoir; Mead et al, 2014). These routes are fraught with issues, as fluid injection into the small ventricular spaces increases intracranial pressure and has been associated with hemorrhage, leakage of cerebrospinal fluid (CSF), and infection (Misra et al, 2003;Mead et al, 2014). Additionally, there is evidence that administration of drug into the CSF does not necessarily increase drug transport into the brain parenchyma (Pardridge, 2011).…”

Section: Types Of Biomaterials Used In the Brainmentioning

confidence: 99%

Harnessing the Potential of Biomaterials for Brain Repair after Stroke

2018

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“…In one retrospective study of 616 patients who had Ommaya reservoirs implanted, 34 patients were identified as having infections. [67] Perioperative infections were diagnosed in 32% of these patients, whereas the remainder were attributed to faulty aseptic technique when the reservoir was accessed. Ommaya reservoirs were present in these patients for a median of 316 days and the infection rate was 0.74 infections per 10,000 "Ommaya days".…”

Section: Nosocomial Infectionmentioning

confidence: 99%

Intracerebroventricular drug administration

Atkinson

2017

Transl Clin Pharmacol

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Among the various routes of drug administration, perhaps the least studied is intracerebroventricular (ICV) administration. This route has been shown to be particularly useful in administering to the central nervous system (CNS) drugs that do not cross the blood-brain barrier readily. As such, the ICV route is a valuable option for providing therapeutic CNS drug concentrations to treat patients with CNS infectious and neoplastic diseases. This route of drug administration also has the advantage of minimizing systemic toxicity.

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Ommaya reservoir infections: A 16-year retrospective analysis

Cited by 51 publications

References 16 publications

Survey of Techniques Utilized to Access Ventricular Shunts and Reservoirs

Survey of Techniques Utilized to Access Ventricular Shunts and Reservoirs

Harnessing the Potential of Biomaterials for Brain Repair after Stroke

Intracerebroventricular drug administration

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