Comparison of percutaneous ventriculostomies and intraparenchymal monitor: a retrospective evaluation of 156 patients.
Intraventricular catheters (IVC) and Intraparenchymal fiberoptic catheters (IPC) are the prevalent methods of intracranial pressure (ICP) monitoring. This study assesses the complications caused by either method. Previous studies have shown a higher complication rate with IVC. In 156 consecutive patients, with IVC (n = 104) or IPC (n = 52) insertion, the demographics, Glasgow coma score (GCS), ICP, duration of monitoring, changes in monitoring device, complications and computerized tomography findings, were recorded. The patients were categorized into severe (GCS 3-8), moderate (GCS 9-12) and mild (GCS 13-15) groups. A retrospective, comparative analysis of both techniques was conducted, using Kruskal-Wallis one way analysis of variance with chi square approximation and Mann-Whitney U tests. The use of IPC at 86.5% predominated in patients with GCS 3-8, while IVC at 81.4% and 92% prevailed in GCS groups 9-12 and 13-15, respectively (p = 0.000). 43.2% IVC were used for 10+ days and 25.9% for 1-3 days, while 80% of IPC were used for less than 6 days (p = 0.000). The complication rate for IVC and IPC was 25% vs 4.4% (p = 0.000). The infection rate was 4.4% and 0.6% (p = 0.1) while, inadvertent removal 4.4% vs 1.2% (p = 0.4), respectively. Malpositions occurred only with IVC (20.1%). All documented complications were without untoward clinical sequelae. We conclude that, IVC remains comparable to IPCs in complications.
Department of Neurosurgery Head Injury Program, Hartford Hospital, University of Connecticut School of Medicine, Hartford, USA.
S H
SH
Khan
I U
IU
Kureshi
T
T
Mulgrew
S Y
SY
Ho
H C
HC
Onyiuke
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D015331:Cohort Studies; D003428:Cross Infection / Q000209:etiology; D019544:Equipment Failure Analysis; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000295:instrumentation*