Ventriculostomy-Related Infections

C. Glen Mayhall, Nancy H. Archer, V. Archer Lamb, Alice C. Spadora, Jane W. Baggett, John D. Ward, Raj K. Narayan

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435 Scopus citations

Abstract

We conducted a prospective epidemiologic study of ventriculostomy-related infections (ventriculitis or meningitis) in 172 consecutive neurosurgical patients over a two-year period to determine the incidence, risk factors, and clinical characteristics of the infections. Ventriculitis or meningitis developed in 19 of 172 patients (11 per cent) undergoing a total of 213 ventriculostomies. When data from all these cases plus five cases of nonventriculostomy-related infection were combined, cerebrospinal-fluid pleocytosis was more significantly associated with the diagnosis of ventriculitis or meningitis (P<0.0001) than were fever and leukocytosis (P = 0.07). Risk factors for ventriculostomy-related infections included intracerebral hemorrhage with intraventricular hemorrhage (P = 0.027), neurosurgical operations (P = 0.016), intracranial pressure of 20 mm Hg or more (P = 0.019), ventricular catheterization for more than five days (P = 0.017), and irrigation of the system (P = 0.021). Previous ventriculostomy did not increase the risk of infection with subsequent procedures. We conclude that ventriculostomy-related infections may be prevented by maintenance of a closed drainage system and by early removal of the ventricular catheter. If monitoring is required for more than five days, the catheter should be removed and inserted at a different site. (N Engl J Med 1984; 310:553–9.).

Original languageEnglish (US)
Pages (from-to)553-559
Number of pages7
JournalNew England Journal of Medicine
Volume310
Issue number9
DOIs
StatePublished - Mar 1 1984

ASJC Scopus subject areas

  • Medicine(all)

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    Mayhall, C. G., Archer, N. H., Lamb, V. A., Spadora, A. C., Baggett, J. W., Ward, J. D., & Narayan, R. K. (1984). Ventriculostomy-Related Infections. New England Journal of Medicine, 310(9), 553-559. https://doi.org/10.1056/NEJM198403013100903