Reducing external ventricular drain associated ventriculitis: An improvement project in a level 1 trauma center

Reiter, Laura; Taylor, Olga L.; Jatta, Maimuna; Plaster, Shannen E.; Cannon, Joseph D.; McDaniel, Bradford L.; Anglin, Mia; Lockhart, Ellen Rachel; Harvey, Ellen M.

doi:10.1016/j.ajic.2022.08.029

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…Some of the practices include strict asepsis with full barrier precautions for procedures involving EVD manipulation; minimizing EVD handling; stopping routine culturing; using standardized EVD dressings and changing dressings only when compromised; and development of an EVD transport protocol. After the implementation of the bundle, the rate of EVD-associated ventriculitis decreased from 8.8 per reported EVD days in 2019 to 0 per reported EVD days in 2021 [44]. A combination protocol and different strategies need to be evaluated after implementation in order to achieve reduction in infection rates, which can take years [45].…”

Section: Discussionmentioning

confidence: 99%

Healthcare-Associated Ventriculitis in Children during COVID-19 Pandemic: Clinical Characteristics and Outcome of a First Infection

Licona-Enríquez,

Labra-Zamora,

Ramírez-Reyes

et al. 2023

Antibiotics

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During the COVID-19 pandemic, patients in need of neurosurgical care suffered. Elective procedures were postponed, and emergency care visits decreased. Healthcare-associated ventriculitis (HAV) is a serious problem in children, with poor outcomes and frequent relapses. Our objective was to describe the clinical characteristics and the factors associated with a first HAV in children during two years of the pandemic. A retrospective cross-sectional study was performed from January 2021 to December 2022. The inclusion criteria were patients who developed a first HAV after a primary cerebrospinal fluid diversion procedure. The controls included patients without a first infection. Intraoperative and clinical data were extracted from medical records. A total of 199 CSF diversion surgeries were registered. A first infection occurred in 17 patients (8.5%), including 10 with external ventricular drain (EVD) and 6 with ventricular shunts. Gram-positive cocci were identified in 70.6%. Six patients recovered uneventfully, eight had relapse or superinfections, and three eventually died. Twenty patients were included as controls. Factors associated with a first infection were a younger age (median 9 vs. 102 months, p < 0.01), malnutrition (23.5% vs. 0%, p = 0.03), and an EVD placement (58.8% vs. 10%, p = 0.03). None of the intraoperative factors showed statistically significant differences. The rate of HAV was high. Most cases presented in children <1 year and with an EVD.

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Section: Discussionmentioning

confidence: 99%

Healthcare-Associated Ventriculitis in Children during COVID-19 Pandemic: Clinical Characteristics and Outcome of a First Infection

Licona-Enríquez,

Labra-Zamora,

Ramírez-Reyes

et al. 2023

Antibiotics

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“…On the other hand, external ventricular drainage involves the insertion of a catheter into the ventricular system to facilitate the drainage of cerebrospinal fluid outside the body. This procedure is commonly employed for acute traffic hydrocephalus and serves as a temporary measure to alleviate pressure within the ventricles before definitive treatment is undertaken [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

A Review of Cerebrospinal Fluid Circulation and the Pathogenesis of Congenital Hydrocephalus

Zhang,

Hu,

Wang

2024

Neurochem Res

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The brain’s ventricles are filled with a colorless fluid known as cerebrospinal fluid (CSF). When there is an excessive accumulation of CSF in the ventricles, it can result in high intracranial pressure, ventricular enlargement, and compression of the surrounding brain tissue, leading to potential damage. This condition is referred to as hydrocephalus. Hydrocephalus is classified into two categories: congenital and acquired. Congenital hydrocephalus (CH) poses significant challenges for affected children and their families, particularly in resource-poor countries. Recognizing the psychological and economic impacts is crucial for developing interventions and support systems that can help alleviate the distress and burden faced by these families. As our understanding of CSF production and circulation improves, we are gaining clearer insights into the causes of CH. In this article, we will summarize the current knowledge regarding CSF circulation pathways and the underlying causes of CH. The main causes of CH include abnormalities in the FoxJ1 pathway of ventricular cilia, dysfunctions in the choroid plexus transporter Na+-K+-2Cl- contransporter isoform 1, developmental abnormalities in the cerebral cortex, and structural abnormalities within the brain. Understanding the causes of CH is indeed crucial for advancing research and developing effective treatment strategies. In this review, we will summarize the findings from existing studies on the causes of CH and propose potential research directions to further our understanding of this condition.

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The Role of Nursing Care in the Management of External Ventricular Drains on the Neurosurgical Ward: A Quality Improvement Project

et al. 2023

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Reducing external ventricular drain associated ventriculitis: An improvement project in a level 1 trauma center

Cited by 5 publications

References 22 publications

Healthcare-Associated Ventriculitis in Children during COVID-19 Pandemic: Clinical Characteristics and Outcome of a First Infection

Healthcare-Associated Ventriculitis in Children during COVID-19 Pandemic: Clinical Characteristics and Outcome of a First Infection

A Review of Cerebrospinal Fluid Circulation and the Pathogenesis of Congenital Hydrocephalus

The Role of Nursing Care in the Management of External Ventricular Drains on the Neurosurgical Ward: A Quality Improvement Project

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