Evidence-Based Management of External Ventricular Drains

David Y. Chung; Dai Wai M. Olson; Sayona John; Wazim Mohamed; Monisha A. Kumar; Bradford B. Thompson; Guy A. Rordorf

doi:10.1007/s11910-019-1009-9

Evidence-Based Management of External Ventricular Drains

David Y. Chung, Dai Wai M. Olson, Sayona John, Wazim Mohamed, Monisha A. Kumar, Bradford B. Thompson, Guy A. Rordorf

Research output: Contribution to journal › Review article › peer-review

24 Scopus citations

Abstract

Purpose of Review: The optimal management of external ventricular drains (EVD) in the setting of acute brain injury remains controversial. Therefore, we sought to determine whether there are optimal management approaches based on the current evidence. Recent Findings: We identified 2 recent retrospective studies on the management of EVDs after subarachnoid hemorrhage (SAH) which showed conflicting results. A multicenter survey revealed discordance between existing evidence from randomized trials and actual practice. A prospective study in a post-traumatic brain injury (TBI) population demonstrated the benefit of EVDs but did not determine the optimal management of the EVD itself. The recent CLEAR trials have suggested that specific positioning of the EVD in the setting of intracerebral hemorrhage with intraventricular hemorrhage may be a promising approach to improve blood clearance. Summary: Evidence on the optimal management of EVDs remains limited. Additional multicenter prospective studies are critically needed to guide approaches to the management of the EVD.

Original language	English (US)
Article number	94
Journal	Current neurology and neuroscience reports
Volume	19
Issue number	12
DOIs	https://doi.org/10.1007/s11910-019-1009-9
State	Published - Dec 1 2019

Keywords

External ventricular drain
Length of stay
Vasospasm
Ventriculoperitoneal shunt
Wean

ASJC Scopus subject areas

General Neuroscience
Clinical Neurology

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10.1007/s11910-019-1009-9

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title = "Evidence-Based Management of External Ventricular Drains",

abstract = "Purpose of Review: The optimal management of external ventricular drains (EVD) in the setting of acute brain injury remains controversial. Therefore, we sought to determine whether there are optimal management approaches based on the current evidence. Recent Findings: We identified 2 recent retrospective studies on the management of EVDs after subarachnoid hemorrhage (SAH) which showed conflicting results. A multicenter survey revealed discordance between existing evidence from randomized trials and actual practice. A prospective study in a post-traumatic brain injury (TBI) population demonstrated the benefit of EVDs but did not determine the optimal management of the EVD itself. The recent CLEAR trials have suggested that specific positioning of the EVD in the setting of intracerebral hemorrhage with intraventricular hemorrhage may be a promising approach to improve blood clearance. Summary: Evidence on the optimal management of EVDs remains limited. Additional multicenter prospective studies are critically needed to guide approaches to the management of the EVD.",

keywords = "External ventricular drain, Length of stay, Vasospasm, Ventriculoperitoneal shunt, Wean",

author = "Chung, {David Y.} and Olson, {Dai Wai M.} and Sayona John and Wazim Mohamed and Kumar, {Monisha A.} and Thompson, {Bradford B.} and Rordorf, {Guy A.}",

note = "Funding Information: This work was supported by the National Institutes of Health (R25NS065743, KL2TR002542, and K08NS112601); the American Heart Association and American Stroke Association (18POST34030369); the Andrew David Heitman Foundation; the Aneurysm and AVM Foundation; and the Brain Aneurysm Foundation{\textquoteright}s Timothy P. Susco and Andrew David Heitman Foundation Chairs of Research. Publisher Copyright: {\textcopyright} 2019, Springer Science+Business Media, LLC, part of Springer Nature.",

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AU - Rordorf, Guy A.

N1 - Funding Information: This work was supported by the National Institutes of Health (R25NS065743, KL2TR002542, and K08NS112601); the American Heart Association and American Stroke Association (18POST34030369); the Andrew David Heitman Foundation; the Aneurysm and AVM Foundation; and the Brain Aneurysm Foundation’s Timothy P. Susco and Andrew David Heitman Foundation Chairs of Research. Publisher Copyright: © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

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N2 - Purpose of Review: The optimal management of external ventricular drains (EVD) in the setting of acute brain injury remains controversial. Therefore, we sought to determine whether there are optimal management approaches based on the current evidence. Recent Findings: We identified 2 recent retrospective studies on the management of EVDs after subarachnoid hemorrhage (SAH) which showed conflicting results. A multicenter survey revealed discordance between existing evidence from randomized trials and actual practice. A prospective study in a post-traumatic brain injury (TBI) population demonstrated the benefit of EVDs but did not determine the optimal management of the EVD itself. The recent CLEAR trials have suggested that specific positioning of the EVD in the setting of intracerebral hemorrhage with intraventricular hemorrhage may be a promising approach to improve blood clearance. Summary: Evidence on the optimal management of EVDs remains limited. Additional multicenter prospective studies are critically needed to guide approaches to the management of the EVD.

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Evidence-Based Management of External Ventricular Drains

Abstract

Keywords

ASJC Scopus subject areas

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