Ventricular Drainage Sets Can Be Used Following Tumor Surgery, Until CSF Circulation Is Re-Established
Ventricular
drainage sets use a combination of gravity and intercerebral pressure to drain
CSF. The drainage rate depends on the height at which the External Ventricular
Drain (EVD) system is placed relative to the patient's anatomy. Neurosurgeons or neurointensivists use EVD to divert
fluid from the ventricles of the brain and allow for monitoring of intracranial
pressure.
Ventricular
drainage sets can be used
following tumor surgery, until the CSF circulation is re-established and to drain
infected CSF during the treatment of meningitis. It is also used in patients
with a severe head injury to provide both a means of measuring continuous
intracranial pressure and allowing CSF drainage to treat raised continuous
intracranial pressure. To an EVD, the patient
is positioned with head/torso at 45° angle relative to the floor and his/her frontal
scalp is shaved. Surgeons mark Kocher point (approximately 11 cm from the
nasion and 3 cm from the midpupillary line) and prepp and drape patient in the
usual sterile fashion. Surgeons collect regular CSF samples to proactively
monitor development of infection in the setting of EVD. An EVD should not cause
pain however paracetamol will be available as needed. Drainage should not be turned off for longer than
needed, as this can cause the catheter to block.
High
prevalence of hemorrhage boosts demand for ventricular drainage sets.
Intracerebral haemorrhage is a common cause of stroke that displays a worldwide
incidence of 24.6 per 100,000 person-years. Epidemiologic
studies indicate that approximately 87% of strokes in the U.S. are ischemic,
10% are secondary to intracerebral hemorrhage, and another 3% may be secondary
to subarachnoid hemorrhage. Increased intracranial pressure and acute
hydrocephalus caused by intracerebral hemorrhage is managed by placement of an EVD.
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