Infecção na monitoração intraventricular da pressão intracraniana com drenagem contínua do líquido cefalorraquiano. / Infection in the intraventricular monitoring of the intracranial pressure with continuous drainage of cerebrospinal fluid.

AUTOR(ES)

Silvia Rocha Cangussú

DATA DE PUBLICAÇÃO

2006

RESUMO

Intraventricular monitoring of the intracranial pressure (ICP) with continuous drainage of cerebrospinal fluid (CSF) is already a widespread procedure in neurosurgical practice and considered as of great diagnostic, therapeutic and prognostic importance due to its precision. However, as it is an invasive method, it presents a potential risk of complications, the infection being the most frequent. The present study aims at verifying and analyzing the rates of infection originating from this monitoring method of ICP, as well as the rates of its risk factors. The information obtained from case histories and laboratory test files were recorded on two own separate data collection cards and later submitted to statistical tests like the Kruskal-Wallis, Mann-Whitney, Chi-Square, Fisher’s exact test, and Spearman correlation coefficients. Relative and absolute, average and standard deviation frequency were verified, 5% was the significance level utilized for the tests. The population of this study was of 79 patients, 70.9% of which were male averaging 37.7 years of age, this being so that the diagnostics present in 82.3% are related to traumatic head injury followed by intracranial tumors and stroke. All of them made use of antibioticprophylaxis. The ventriculitis rate was of 26.6 %, the catheter remaining, on average, 6.7 days and showing variable daily rates of this infection. We have not found a statistically meaningful association between monitoring time and infection, however there was an increase in the daily ventriculitis rate after the first three days and peaks on the 6th, 9th and 12th days showing a probable non-cumulative or linear link. Other variables evaluated in this study which presented a direct association with the occurrence of ventriculitis were the male sex, subdural hemorrhage and infections at other sites, mainly sepsis. Variables such as age, invasive procedures, open traumatic head injury, CSF leaks, intraventricular hemorrhage, multiple ventriculostomies, presence of ICP above 20mmHg, intercurrences during catheterization or its maintenance did not show association with the ventriculitis rate, nevertheless many of these variables were present in few cases making a definite conclusion difficult.

ASSUNTO(S)

risk factors infecção intracranial pressure monitoring ventriculostomy monitoração da pressão intracraniana ventriculite epidemiologia procedimentos neurocirúrgicos epidemiology infection ventriculitis neurosurgical procedures fatores de risco ventriculostomia

Documentos Relacionados

• Drenagem contínua de líquido cefalorraquidiano com monitoração intermitente de pressão intracraniana em pacientes com tumefação cerebral difusa pós-traumática
• Intraventricular vancomycin in the treatment of ventriculitis associated with cerebrospinal fluid shunting and drainage.
• Cerebrospinal fluid pulse pressure and intracranial volume-pressure relationships.
• Continuous sampling for determination of pharmacokinetics in rat cerebrospinal fluid.
• Cerebrospinal fluid.