gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Open (droplet chamber) versus closed (LiquoGuard™) ventricular drainage

Meeting Abstract

  • Robert Winkler - Klinik für Neurochirurgie, HELIOS Klinikum Erfurt GmbH, Deutschland
  • Christian Icke - Klinik für Anästhesie und Intensivmedizin, HELIOS Klinikum Erfurt GmbH, Deutschland
  • Sabine Recknagel-Friese - Klinik für Anästhesie und Intensivmedizin, HELIOS Klinikum Erfurt GmbH, Deutschland
  • Kai-Uwe Döbel - Klinik für Anästhesie und Intensivmedizin, HELIOS Klinikum Erfurt GmbH, Deutschland
  • Peter Brand - Klinik für Anästhesie und Intensivmedizin, HELIOS Klinikum Erfurt GmbH, Deutschland
  • Rüdiger Gerlach - Klinik für Neurochirurgie, HELIOS Klinikum Erfurt GmbH, Deutschland
  • Steffen Rosahl - Klinik für Neurochirurgie, HELIOS Klinikum Erfurt GmbH, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1614

DOI: 10.3205/10dgnc087, URN: urn:nbn:de:0183-10dgnc0879

Published: September 16, 2010

© 2010 Winkler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Drainage of CSF via an external ventricular drainage in acute hydrocephalus commonly employs an open droplet chamber system. The LiquoGuard-device drains CSF from a ventricular catheter with a micropump in a closed-loop system. We have compared the new device with the conventional open droplet chamber technique regarding safety and efficacy.

Methods: In an ongoing multicentric study 300 patients in 2 treatment arms will be enclosed. The patients are pseudo-randomised, i.e. if the first patient was treated with the droplet chamber (TK), the next one would receive treatment employing the LiquoGuard™ system (LG). Patients younger than 14 years of age have been excluded from the study. Other exclusion criteria were intracranial infection and major intraventricular clotting. Evaluation includes objective criteria (e.g. complications, infection, over- and underdrainage, hemorrhage, time to detection of a complication) and subjective criteria (e.g. handling, overall satisfaction of nursing staff with the respective system).

Results: On abstract submission 122 patients had been enclosed, 62 with the LiquoGuard™-device (LG) and 60 with the common drain system (TK). The cause of the acute hydrocephalus was SAH (39%) followed by ICH (31%). The overall infection rate was 15.6% with 16.1% (LG) vs. 15.0% (TK), (p=0.678). The mean days to the appearance of any intracranial infection was 8.8 (LG) vs. 6.3 (TK) (p=0.124). The most commonly detected complication in use of both systems was the occlusion of the catheter 21.3%; 14.7% (LG) vs. 5.6% (TK) (p=0.3). Underdrainage was detected in 20.5%; 5.7% (LG) vs. 14.8% (TK) (p=0.5). Overdrainage was observed in 2.4% with the droplet chamber system, but no slit ventricles were detected on CT of these patients. Overdrainage was observed in 3.3 % with the LiquoGuard™, interestingly, in 4.1% of these cases slit ventricles were be seen in tomography. The nursing and medical staff from the ICU´s judged a better handling, and felt more comfortable with the LiquoGuard™ system.

Conclusions: At this time the data show comparable results in use of the LiquoGuard™ device and the open droplet chamber with respect to objective criteria while subjectively, the closed system has scored higher on acceptance scores with the nursing staff. The study will be continued as other parameters like final outcome as well as switching from one system to the other will be included in the analysis.