title: [Risk of ventriculitis associated to the care of the ventricular drain in neurocritical patients].
abstract: OBJECTIVE
  To analyze the risk of ventriculitis associated to the care of the external ventricular drain.
  
  
  METHODS
  Case-control study among a sample of neurocritical patients of the University Hospital of Asturias (Spain) who carried a ventricular catheter (n = 127; 49 cases and 78 controls). Main outcome was the diagnosis of ventriculitus, according to established criteria. Independent variables were related to the catheter management, including nursing cares of the insertion point, administration of intrathecal medication, flushes, changes and mobilization of the catheter. Other variables (age, sex, APACHE score, admission diagnosis, comorbidity, antibiotics, time to insertion and permanence time of the drain) were studied as covariates.
  
  
  RESULTS
  Nursing catheter cares (OR 3.8; 95% CI: 1.1-13.9) and administration of intrathecal medication (OR: 7.1; 95% CI: 2.1-23.6) were significantly associated with ventriculitis. After adjustment by the number of days at risk, the effect of nursing cares disappeared (OR 1.4; 95% CI: 0.3-6.6).
  
  
  CONCLUSIONS
  Intrathecal medication and nursing cares seem to be associated with ventriculitis. The administration of medication by the ventricular drain really reflects that the physicians suspect ventriculitis before the diagnosis is confirmed and, therefore, they prescribe this medication. However, as the duration of drain increases the frequency of nursing cares, it seems prudent to recommend not lengthen the permanence of the ventricular drain and to improve the training of nurses.
authors.affiliation: Universidad de Oviedo, Oviedo, Espana.
authors.forename: Aida
authors.initials: A
authors.lastname: Rivas-Rodriguez
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Espana.
authors.forename: Belén
authors.initials: B
authors.lastname: Suarez-Mier
authors.affiliation: Hospital Monte Naranco, 33012 Oviedo, Espana.
authors.forename: Lidia
authors.initials: L
authors.lastname: Rivas-Rodriguez
authors.affiliation: Universidad de Oviedo, Oviedo, Espana.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lana
mesh_terms: D016022:Case-Control Studies; D057785:Catheters / Q000009:adverse effects*; D058565:Cerebral Ventriculitis / Q000453:epidemiology / Q000209:etiology*; D016638:Critical Illness; D004322:Drainage / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk