We investigated the feasibility and safety of ivf followed by early ld for the treatment of posthemorrhagic hydrocephalus. The proximal tip of the catheter sits in a lateral ventricle, and the distal end is connected to a drainage system and pressure transducer. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. External ventricular drainage was performed in these cases at time of surgery. An external ventricular drain is a medical device that can direct cerebrospinal fluid csf from inside the brain to a bag outside the body. Care of the patient with an evd or lumbar drain powerpoint ppt presentation. Microsoft powerpoint establishment of an evd best practice.
External ventricular drain management and ventriculoperitoneal shunt. Determinants of external ventricular drain placement and. Extraventricular drainage system and icp monitoring. Haemorrhagic complications of external ventricular drainage. Ppt chest drains powerpoint presentation free to download. Background and purpose both intraventricular fibrinolysis ivf and lumbar drainage ld may reduce the need for exchange of external ventricular drainage evd and shunt surgery in patients with intracerebral hemorrhage and severe intraventricular hemorrhage. Csf drainage via an external ventricular drain evd or ventriculostomy is a highly effective and physiologic method of icp reduction in headinjured patients. This procedure is used when the icp is elevated, and the drain may be clamped for short periods of time by. An external ventricular drain, also known as an extraventricular drain or ventriculostomy, is a device used in neurosurgery that relieves elevated intracranial pressure and hydrocephalus when the. The burr hole should be placed 11 cm superior and posterior to the nasion and 3 cm lateral. A catheter is placed into the ventricle of the brain connecting to the external drainage container. Drainage systems in india the drainage systems of india are mainly controlled by the broad. Hypertensive caudate hemorrhage prognostic predictor.
Close the 4way stopcock to the extension tube and inject saline through. Discussion the external ventricular derivation is an invasive. Overview of external ventricular drainage and monitoring. The external ventricular drain evd is a small tube surgically inserted into the ventricles of the brain, which drains cerebrospinal fluid csf fig. Monitoring learning package is designed to increase the nurses awareness of the. Before puncturing, the port must be aseptically cleaned to prevent possible contamination.
Overview of external ventricular drainage and monitoring medtronic. Scroll down to read the article or download a printfriendly pdf here. A temporary system that allows drainage of cerebral spinal fluid csf from the ventricles to an external closed system intracranial pressure icp monitoring. Download external ventricular drain medical presentation. View external ventricular drainage ppts online, safely and virusfree.
External ventricular drainage evd or lumbar drainage or externalized ventriculoperitoneal shunt1,2 cerebral spinal fluid is colorless, clear fluid produced in the 3rd thand 4 ventricles of the brain that functions to cushion the brain and spinal cord. The external portion of the ventricular drainage system must be primed before connection to the catheter. External ventricular drainage evd or lumbar drainage or externalized ventriculoperitoneal shunt1,2 cerebral spinal fluid is colorless, clear fluid produced in the 3rd and 4th ventricles of the brain that functions to cushion the brain and spinal cord. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Results of routine ventriculostomy with external ventricular drainage for acute hydrocephalus following sah. External ventricular drainage evd has its own drawbacks. Health care industry catheterization health aspects drainage surgical standards drainage, surgical infection infection control medical research medicine, experimental.
Sep 07, 2015 tunnel catheter through skin away from point of entry through separate incision, suture in place and connect to external drainage system. Role of external ventricular drainage in the management of. External ventricular drain an overview sciencedirect. Generally, an ebook can be downloaded in five minutes or less. Evidencebased information on external ventricular drain from hundreds of trustworthy sources for health and social care. The utility of the ventriculostomy catheter, however, may be compromised in the presence of considerable brain edema and subsequent ventricular collapse. Shunt failure due to mechanical disruption or infection. Common complications of evd treatment include infection and catheterrelated hemorrhage. The objective of this study was to identify the clinical predictors of evd utilization, and associated outcome in adults with spontaneous ivh with or without intracerebral hemorrhage ich. Drainage system showing bloody csf due to intracranial hemorrhage. The quest for a comprehensive, universal standard for evd care problem. Perioperative management of adult patients with external.
Drainage color change turn stopcock off to burette after draining zero q shift, when reconnecting to. External ventricular drainage and neurological critical care. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. An evd is a flexible plastic catheter placed by a neurosurgeon or neurointensivist and managed by intensive care unit. Retrospective series report varied rates of bleeding and infection with external ventricular drainage evd. Studies not written in english were excluded from further evaluation. Ppt care of the patient with an evd or lumbar drain powerpoint. External ventricular drain an overview sciencedirect topics. The absolute average between the clamped drain reading and the openmonitor placement was 1. Intraventricular fibrinolysis and lumbar drainage for. External ventricular drains evds are commonly used in neurosurgery for cerebrospinal fluid diversion and access.
View and download powerpoint presentations on external ventricular drain ppt. Infections of external ventricular drainages springerlink. Extraventricular drainage system and icp monitoring turn stopcock to drain csf in burette to bag q1 hour record amount from chamber on io flowsheet notify neurosurgery if. Infection shunt infection occur in 28% 70% are diagnosed in the 1 st month and 90% by 6 month common organisms are staph epidermidis, aureus, pneumococci shunt tap for microbiological analysis removal of shunt, external ventricular drainage and antibiotics should be given. External drainsexternal drains placed within the ventricle evd or the lumbar thecal sac lumbar drain. Hypertensive caudate hemorrhage prognostic predictor, outcome. A temporary device allowing measurement and recording of intracranial pressur.
These patients were admitted to the university clinical centre maribor between. External ventricular drain evd usage in patients with intraventricular hemorrhage ivh is variable in current practice and in clinical trials, and its impact on outcome remains controversial. External ventriculostomy for cerebrospinal fluid csf drainage or for intracranial pressure monitoring is. Oct 22, 2015 click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download. External ventricular drainage and neurological critical. This catheter monitors and manages the pressure within the brain. Postoperative ventriculitis in external ventricular hemorrhage rates ociated with intracranial pressure monitoring potion pharmaiics of ppt external ventricular drain powerpoint ationexternal ventricular drains management and plicationscaring for neurosurgical patients with external ventricular drainscaring for neurosurgical patients with external ventricular drainsppt care of the patient with. Volume of ventricular blood is an important determinant of outcome in supratentorial intracerebral hemorrhage. Insertion of an external ventricular drain evd is arguably one of the. As part of the hospital infection control program, all patients receiving an external ventricular evd or lumbar drain eld 2004 to 2009. An external ventricular drain may be required as an urgent treatment for acute hydrocephalus associated with rapid deterioration of consciousness level, occurring with ventricular hemorrhage, acute infection, or a cerebral mass lesion. Other topics submitted by msmhcm words 548 pages 3.
Abstract external ventricular drains are lifesaving devices used in. The most common complication of the external ventricular drainage evd is an infection, which is linked to different risk factors. Csf drainage was continued in the postoperative period for a mean of 2. External ventricular drainage evd is common after brain surgery. We tried to investigate possible links between different risk factors and incidences of an infection of the evd. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from.
Water divide any elevated area, such as a mountain or an upland, separates two drainage basins. Intracerebral infusion drainage catheter, shortterm a sterile flexible tube intended to be surgically inserted through the skull for shortterm 30 days subdural access to the brain e. If you have a good external ventricular drain medical presentation, upload the same on for a worthy audience and credits to download external ventricular drain powerpoint templates along with other premium content. We used a retrospective method and examined records of 176 patients. Dec 17, 2014 external ventricular drain gold standard for icp monitoring. External ventricular drains evd and lumbar drains ld are temporary devices placed into the lateral ventricles of the brain and lumbar subarachnoid space respectively, to facilitate external cerebrospinal fluid csf drainage and to monitor csf pressure.
Dec 23, 2015 external ventricular drainage evd has its own drawbacks. Rare complication of external ventricular drainage. Infections cannot be avoided even with the best surgical technique and aseptic handling measures. Of 148 patients with infratentorial brain tumours which were operated upon during a 5 year period, 59 patients had associated obstructive hydrocephalus, as evidenced by preoperative ct scan. In addition, drain should also be clamped during transfer and transport. In a metaanalysis of studies of evds, the overall incidence of infection among highquality studies. Automated detection of external ventricular and lumbar. Response to external ventricular drainage in spontaneous intracerebral hemorrhage with hydrocephalus. Age, gender, volume of parenchymal hematoma, hematoma in the internal capsule. An evaluation of commonly used external ventricular drain. Establishment of an external ventricular drain evd best practice guideline. Perioperative management of external ventricular evd and.
The external ventricular drain evd and intracranial pressure icp. Csf reservoir and clamp evd or lumbar csf drain immediately prior to transfer and place the. Establishment of an external ventricular drain best practice guideline. An external ventricular drain evd, also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid csf inside the brain is obstructed. However, the incidence of evdrelated infection eri is still relatively high and can increase morbidity and mortality. Gravity and the pressure inside the head typically help to drain the csf, which can build up as a result of injury, infection, surgery, or other conditions. External ventricular drainage intracranial pressure refers to the pressure exerted by the brain, blood and cerebrospinal fluid in the skull. The tube is connected to a device that measures the amount of this fluid. An external ventricular drainage evd system drains csf by using a combination of. Early diagnosis of external ventricular drainage infection. The cerebral perfusion pressure indirectly reflects the adequacy of. Catheters impregnated with antibiotics rifampicin and minocyclin or rifampicin and clyndamycin reduce the frequency of positive csf cultures. Despite the widespread use of external ventricular drainage, revision rates, and associated complications are reported between 10 and 40%. Establishment of an external ventricular drain best practice.
Drainage may be indicated to control increased intracranial pressure or. The aim of this study was to evaluate the influence of total drainage time on the risk of catheter infection, and the predictive value of standard laboratory examinations for the diagnosis of bacteriologically recorded cerebrospinal fluid csf infection during external ventricular drainage. Infections are a serious complication of external ventricular drainage. An external ventricular drainage evd system drains csf by using a combination of gravity and intercerebral pressure. Evd dislodgement can lead to significant morbidity and mortality, particularly through an increased risk of ventriculitis through cerebrospinal fluid leakage, which. During a three year period, all patients of the neurosurgical intensive care unit.
There have been no prospective studies of these risks with systematic surveillance, threshold definitions, or independent adjudication. Waveform analysis concluded similar wave forms with the openmonitor and clamped methods with the clamped methods being more accurate for interpretation of compliance. Download figure open in new tab download powerpoint. Click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download. B drainage basin the area drained by a single river system is called a drainage basin. Care of the patient undergoing intracranial pressure. External drainage and monitoring is the temporary drainage of cerebrospinal fluid csf from the lateral ventricles of the brain, or the lumbar space of the spine, into an external collection bag. Because acute hydrocephalus is a surgical emergency, a temporary drain can be used. Their placement is considered one of the most frequently. External ventricular drain management and ventriculoperitoneal shunts. Bleeding and infection with external ventricular drainage. Evd dislodgement can lead to significant morbidity and mortality, particularly through an increased risk of ventriculitis through cerebrospinal fluid leakage, which can be fatal despite treatment.
Automated detection of external ventricular and lumbar drain. Perioperative management of external ventricular and lumbar drain. Management of the patient with an external ventricular drain. Intraventricular hemorrhage ivh occurs in 30% to 50% of spontaneous intracerebral hemorrhage ich and is frequently complicated by acute obstructive hydrocephalus. Establishment of an external ventricular drain best. Indications for an evd or icp monitor can include hydrocephalus, haemorrhage, tumour, meningitis or traumatic. Caring for neurosurgical patients with external ventricular drains. Ppt external ventricular drain powerpoint presentation, free. Background and purposethe purpose of the present study was to analyze the outcome and outcome predictors of caudate hemorrhage and role of external ventricular drainage in acute hydrocephalus methodsclinical data from 36 consecutive patients with hypertensive caudate hemorrhage was used in the present study. Nov 24, 2015 an external ventricular drain, also known as an extraventricular drain or ventriculostomy, is a device used in neurosurgery that relieves elevated intracranial pressure and hydrocephalus when the.
Perioperative external ventricular drainage in obstructive. The accudrain external csf drainage systems can be used with all of the integra neurosciences ventricular and lumbar catheters. External ventricular drainage evd is one of the most common and effective procedures in. External ventricular drains evds are devices commonly used in neurocritical care. Introduction hydrocephalus is an abnormal enlargement of the ventricles due to an excessive accumulation of cerebrospinal fluid csf and thinning of cerebral mantle resulting from a disturbance of csf flow, absorption or, uncommonly secretion. Using aseptic technique, fill a syringe with sterile saline. The exacta external drainage and monitoring system is designed for ventricular or lumbar drainage with a small disposable system and a reusable poleclamp scale with integrated laser level. The subdural evacuating port system is an innovative, minimally. A tubing connector with a luer connector is provided to facilitate the catheter connection to the drainage system. Tunnel catheter through skin away from point of entry through separate incision, suture in place and connect to external drainage system. Find powerpoint presentations and slides using the power of, find free presentations research about external ventricular drain ppt. Data quality was evaluated and recommendations for practice were estab. How to place an external ventricular drain evd peripheral. External ventricular drains and intracranial pressure monitoring.
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