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Antibiotic-Impregnated Versus Silver-Bearing External Ventricular Drainage Catheters: Preliminary Results in a Randomized Controlled Trial

Winkler, K. ; Woernle, C. ; Seule, M. ; Held, U. ; Bernays, R. ; Keller, E.

In: Neurocritical Care, 2013, vol. 18, no. 2, p. 161-165

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    Titel
    • Antibiotic-Impregnated Versus Silver-Bearing External Ventricular Drainage Catheters: Preliminary Results in a Randomized Controlled Trial
    Autor
    • Winkler, K.. Neurosurgical Intensive Care Unit, University Hospital Zurich, Zurich, Switzerland
    • Woernle, C.. Department of Neurosurgery, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, Switzerland
    • Seule, M.. Neurosurgical Intensive Care Unit, University Hospital Zurich, Zurich, Switzerland
    • Held, U.. Horten Centre for Patient Oriented Research and Knowledge Transfer, University Hospital Zurich, Zurich, Switzerland
    • Bernays, R.. Department of Neurosurgery, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, Switzerland
    • Keller, E.. Neurosurgical Intensive Care Unit, University Hospital Zurich, Zurich, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Neurocritical Care, 2013, vol. 18, no. 2, p. 161-165. Humana Press Inc
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:312542
    Summary
    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