Abstract
Background
Evaluation of antibiotic-impregnated (AI) and ionized silver particle coated external ventricular drainage catheters (EVD) in patients with subarachnoid (SAH) or intracranial hemorrhage (ICH).
Methods
Between February 2011 and June 2012, 40 patients with acute hydrocephalus due to SAH, ICH or intraventricular hemorrhage were enrolled in a prospective, randomized, mono-center pilot study. Primary endpoints were defined as: number of events of cerebrospinal fluid (CSF) infections. Secondary endpoints were defined as: neurosurgical complications following the placement of the EVD, number of revisions of EVD catheters, and cost effectiveness.
Results
Sixty-one EVD placements in 40 patients, 32 antibiotic-coated (Bactiseal®), 29 silver-bearing catheters (VentriGuard®), have been performed. Confirmed or high suspicion of CSF infections occurred in 11 out of 61 events (confirmed infection: p = 0.71, probable infection: p = 0.90). Revisions of EVD were needed in 13 cases (22 %) due to CSF infection, dysfunction, impaired healing, or malplacement (p = 0.37).
Conclusion
Regarding CSF infection rate and dysfunction, no statistical significant differences between the two EVD catheters Bactiseal® versus VentriGuard® were found. The silver-bearing catheter might offer a safe and cost-conscious alternative to the AI catheter.
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Acknowledgments
We thank Mrs. M. Winter for her help in the data collection and secretarial work.
Disclosures
The principal investigator initiated study was partially financed by Neuromedex® GmbH, Zollikon, Switzerland, who provided the silver-bearing EVD catheters for free. The authors have no personal or financial or institutional interest in any drugs, materials, or devices described in this article. This study is registered with the national ethic approval (KEK-ZH-Nr: 2010-214).
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KML Winkler and CM Woernle have contributed equally.
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Winkler, K.M.L., Woernle, C.M., Seule, M. et al. Antibiotic-Impregnated Versus Silver-Bearing External Ventricular Drainage Catheters: Preliminary Results in a Randomized Controlled Trial. Neurocrit Care 18, 161–165 (2013). https://doi.org/10.1007/s12028-013-9816-3
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DOI: https://doi.org/10.1007/s12028-013-9816-3