Objective: To determine the surgical outcome of intraventricular hemorrhage extraction using a drainage system, its complications and management.
Methodology: This prospective clinical trial was conducted for a period of 3 years at Civil Hospital Karachi, Pakistan. The study population consisted of 150 patients who underwent the closed system external drainage procedure for the drainage of ventricular hemorrhage. Various parameters were noted and data were analyzed using SPSS version 23.
Results: A total of 150 patients underwent 175 ventriculostomies. Ventriculostomy infection developed in 38 (25.33%) patients. Overall mortality rate was 30% (n=45). Age, gender, prophylactic antibiotics, steroid use and surgical diagnosis did not show any association with infection. Among all those who were infected, the culture was positive in 85.71% patients. The infection was of polymicrobial in 19 patients and unimicrobial in 11. Co-existing sepsis was present in 65 patients, while 31 patients had an open source of infection like tracheostomy, pressure sore, or wound infection. In 105 (70%) patients, the ventriculostomy catheter was not changed. In 30 patients, the catheter was changed only one time, in 8 patients it was changed twice and in 7 it was changed three times. Fifteen patients belonging to the non infected group had a catheter change, while 22 catheters were changed in the infection group.
Conclusion: There was an exponential increase in the rate of infection after 5 days of putting in the external catheter. Therefore, it is necessary that extraventricular drainage by closed system only to be placed when it is very necessary and the ventriculostomy should only be kept for the duration that is required. Monitoring should be done on a daily basis to prevent the complications.
Key words: Ventricular hemorrhage, ventriculostomy, external ventricular drainage, neurosurgical procedure, intracranial infection.
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