Some cool considerations of external lumbar drainage during its widespread application in neurosurgical practice: a long way to go

Li, Guichen; Zhang, Yang; Zhao, Jinchuan; Han, Zhiguo; Zhu, Xiaodong; Hou, Kun

doi:10.1186/s41016-016-0033-8

Cited by 4 publications

(4 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Complications are frequently reported, and meningitis is a common complication of lumbar drainage. The incidence varies among different reports between 5-30% but could be higher than 40% 6 . These large variations in infection rates are due a myriad of reasons, such as the primary diseases, drain indwelling procedures, patient population, and use of prophylactic antibiotics.…”

Section: Accepted Manuscriptmentioning

confidence: 96%

“…The incidence varies among different reports between 5 and 30% but could be higher than 40%. 6 These large variations in infection rates are due to a myriad of reasons, such as primary diseases, drain indwelling procedures, patient population, and use of prophylactic antibiotics. Furthermore, most parts of the studies are a mixture of lumbar and external ventricular drainages, preventing knowing the real number of infections by LCs.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of the Lumbar Catheter on the Incidence of Postsurgical Meningitis in the Endoscopic Endonasal Approach

Maskin,

Noya,

Caffaratti

et al. 2024

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Objectives: Endoscopic endonasal approach (EEA) procedures are inherently contaminated due to direct access through the nasopharyngeal mucosa. The reported rate of postoperative meningitis in EEA procedures is between 0.7%-10%. Lumbar catheters are used in EEA surgeries to prevent cerebrospinal fluid (CSF) fistulae, but its use is associated with increase infection rates. This study investigated whether there is a difference in rates of postoperative meningitis based on lumbar catheter utilization. Methods: We performed a retrospective review of consecutive patients who underwent EEA surgeries between January 2016 and March 2023 at single-institution (FLENI). Main outcome: Incidence of meningitis following EEA surgery with lumbar catheter. Results: seventy-two patients were enrolled, median age was 44 years, and 53% were female. Most frequent surgery performed was craniopharyngioma 46% (26 patients). Lumbar catheter was used in twenty-eight patients. Meningitis was diagnosis in 11 of 72 patients (15.2%), being higher in the lumbar catheter group (10 patients). The odds ratio for the development of meningitis in the presence of a lumbar catheter was 23.38 (95% confidence interval, 2.77-123.78; p < 0.004). There was no statistical difference in reported incidence of meningitis when CSF leak was present. Conclusions: This study demonstrates an extremely high incidence of meningitis (36%) following EEA procedures when lumbar catheter is used. The incidence of meningitis was not significantly associated with CSF leak in our cohort.

show abstract

Section: Accepted Manuscriptmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Impact of the Lumbar Catheter on the Incidence of Postsurgical Meningitis in the Endoscopic Endonasal Approach

Maskin,

Noya,

Caffaratti

et al. 2024

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

show abstract

“…Tujuan aspirasi CSF adalah untuk membantu mengurangi tekanan intra kranial sehingga otak lebih rileks. 17 Otak yang lebih rileks membuat tegangan duramater berkurang yang akan membantu memisahkan kranium dengan duramater. Rekomendasi mengatakan bahwa pemeliharaan anestesi teknik seimbang dengan fokus menjaga stabilitas kardiovaskular agar perfusi ke otak terjaga dapat menggunakan agen inhalasi atau intravena dikombinasikan dengan opioid memungkinkan manipulasi kedalaman anestesi selama berbagai tahapan prosedur.…”

Section: Pembahasanunclassified

Manajemen Low Flow Anesthesia pada Pasien Kraniosinostosis dengan Hipertelorisme yang menjalani Four Box Wall Osteotomy, dan Eksisi Redundant Skin Fronto Nasal

Syarif¹,

Bisri

Harahap

et al. 2021

JNI

View full text Add to dashboard Cite

Craniosynostosis is a case that diagnosed in the first year of life and can need surgical in young age. Craniosynostosis is a part of hypertelorism with incidence rate around 20%. Boy, 13 years old with hypertelorism had undergone multiple surgery for correction of hypertelorism before. Patient was planned to advance surgical correction of four box wall osteotomy which consist frontal part correction and part of it is release craniosynostosis in coronal suture. Risk of massive bleeding because patient already in teen age and length of surgery can be prolonged. Difficult airway management due to fascial deformity, use of low flow anesthesia to preserve temperature and reduce inhalation anesthesia usage, intraoperative fluid management in consideration maintenance and replacement blood loss and post operative pain management has become another consideration. Covid-19 as part of problems post operatively being known before extubation made the process is delayed. Massive bleeding needs massive transfusion protocol to speed up blood availability. Blood product such as PRC, FFP and TC should be available because coagulation factor is part of consideration. Anesthesia management in hypertelorism with four box wall osteotomy need good communication between anesthesiologist, neurosurgeon, plastic surgeon and pediatric intensivist to reduce perioperative risk including covid-19 in pandemic era.

show abstract

“…However, the risks from LD are frequent and need to be noticed, although LD placement is often viewed as benign ( 2 ). One of the most common complications is lumbar drainage-related meningitis (LDRM), which has diverse incidence in different reports, usually as 3–20%, and a few may be as high as 40% ( 14 ). This complication can prolong the hospital stay, increase medical expenses, and even lead to catastrophic outcomes ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

Prediction of Lumbar Drainage-Related Meningitis Based on Supervised Machine Learning Algorithms

Wang

Cheng

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

BackgroundLumbar drainage is widely used in the clinic; however, forecasting lumbar drainage-related meningitis (LDRM) is limited. We aimed to establish prediction models using supervised machine learning (ML) algorithms.MethodsWe utilized a cohort of 273 eligible lumbar drainage cases. Data were preprocessed and split into training and testing sets. Optimal hyper-parameters were archived by 10-fold cross-validation and grid search. The support vector machine (SVM), random forest (RF), and artificial neural network (ANN) were adopted for model training. The area under the operating characteristic curve (AUROC) and precision-recall curve (AUPRC), true positive ratio (TPR), true negative ratio (TNR), specificity, sensitivity, accuracy, and kappa coefficient were used for model evaluation. All trained models were internally validated. The importance of features was also analyzed.ResultsIn the training set, all the models had AUROC exceeding 0.8. SVM and the RF models had an AUPRC of more than 0.6, but the ANN model had an unexpectedly low AUPRC (0.380). The RF and ANN models revealed similar TPR, whereas the ANN model had a higher TNR and demonstrated better specificity, sensitivity, accuracy, and kappa efficiency. In the testing set, most performance indicators of established models decreased. However, the RF and AVM models maintained adequate AUROC (0.828 vs. 0.719) and AUPRC (0.413 vs. 0.520), and the RF model also had better TPR, specificity, sensitivity, accuracy, and kappa efficiency. Site leakage showed the most considerable mean decrease in accuracy.ConclusionsThe RF and SVM models could predict LDRM, in which the RF model owned the best performance, and site leakage was the most meaningful predictor.

show abstract

Some cool considerations of external lumbar drainage during its widespread application in neurosurgical practice: a long way to go

Cited by 4 publications

References 72 publications

Impact of the Lumbar Catheter on the Incidence of Postsurgical Meningitis in the Endoscopic Endonasal Approach

Impact of the Lumbar Catheter on the Incidence of Postsurgical Meningitis in the Endoscopic Endonasal Approach

Manajemen Low Flow Anesthesia pada Pasien Kraniosinostosis dengan Hipertelorisme yang menjalani Four Box Wall Osteotomy, dan Eksisi Redundant Skin Fronto Nasal

Prediction of Lumbar Drainage-Related Meningitis Based on Supervised Machine Learning Algorithms

Contact Info

Product

Resources

About