Management of External Ventricular Drains After Subarachnoid Hemorrhage: A Multi-Institutional Survey.
David Y ChungThabele M Leslie-MazwiAman B PatelGuy A RordorfPublished in: Neurocritical care (2018)
Most institutions utilize a single predominant EVD management approach, with a consensus toward a continuously open EVD to enhance CSF drainage in secured aneurysm patients coupled with a gradual weaning strategy. This finding is surprising given that the best available evidence suggests that the opposite approach is safe and can reduce ICU and hospital length of stay. We recommend a critical reassessment of the approach to the management of EVDs. Given the potential impact on patient outcomes and length of stay, more research needs to be done to reach a threshold for practice change, ideally via multicenter and randomized trials.
Keyphrases
- subarachnoid hemorrhage
- brain injury
- healthcare
- end stage renal disease
- mechanical ventilation
- chronic kidney disease
- intensive care unit
- coronary artery
- newly diagnosed
- primary care
- ejection fraction
- prognostic factors
- left ventricular
- blood brain barrier
- atrial fibrillation
- patient reported outcomes
- ultrasound guided
- electronic health record
- human health