Eksternal ventriküler drenaj sisteminin klinik etkileri, olasi komplikasyonlari ve komplikasyon yönetimi

Öz

AMAÇ: Bu çalışmanın amacı, uygulanan eksternal ventriküler drenaj sisteminin mortalite üzerine etkisini, oluşabilecek komplikasyonları ve komplikasyonların yönetiminin ortaya konmasıdır. GEREÇ VE YÖNTEM : Ocak 2016 – Kasım 2018 ayları arasında XXXX Üniversitesi Beyin Cerrahisi Kliniğinde eksternal ventriküler drenaj sistemi takılmış toplam 128 hasta retrospektif olarak tarandı. Hastalar yaş, cinsiyet, endikasyon, başvuru anındaki bilinç düzeyleri, sistemik enfeksiyon varlığı, sekonder komplikasyonlar açısından araştırıldı. Eksternal ventriküler drenaj uygulamasının klinik sonlanım üzerine etkileri değerlendirildi. BULGULAR: Çalışma boyunca 128 hastaya toplamda 176 kez ventrikülostomi uygulandı. Yaş aralığı 1-88 arasında 73 erkek, 55 kadın hasta vardı. Hastaneye başvuru anında ortalama GKS değeri 64 hastada 7’ nin altında idi. Toplam 38 hastada ventrikülit gelişti. Başvuru anında 8 hastada sistemik enfeksiyon ve antibiotik kullanım öyküsü tespit edildi. 52 hasta takipler sonucunda kaybedildi. SONUÇ: Eksternal ventriküler drenaj sistemi acil şartlarda kafa içi basıncı düşürmek amacıyla uygulanan ve klinik sağ kalım üzerine olumlu etkileri bulunan bir sistemdir. En sık ve en mortal komplikasyon enfeksiyon gelişimidir. Drenaj sistemi sadece kesinlikle gerekli olan durumlarda ve belirli protokollere göre yapılmalı, ventrikülostomi gerekli süre boyunca tutulmalı ve 5 gün sonra enfeksiyondaki üssel artış göz önüne alınarak hastalar yakın takip edilmelidir.

Anahtar Kelimeler

• Eksternal Ventriküler Drenaj Sistemi,ventrikülit,mortalite

Clinical effects of external ventricular drainage system, potential complications and complication management

Öz

Purpose: The aim of this study is to reveal the effect of external ventricular drainage system on mortality, potential complications and management of complications. Materials and Methods: Data of 128 patients undergoing external ventricular drain placement procedure at XXX University Department of Neurosurgery between January 2016 and November 2018 were screened retrospectively. Age, sex, indication, level of consciousness at the time of admission, presence of systemic infection, and secondary complications of the patients were examined. The effects of external ventricular drainage on clinical outcome were evaluated. Results: A total of 176 ventriculostomies were performed in 128 patients during the study. There were 73 male and 55 female patients with an age range of 1-88 years. The mean Glasgow Coma Scale at admission was ≤7 in 64 patients. Ventriculitis developed in a total of 38 patients. Systemic infection and antibiotic use history were detected in eight patients at admission. Fifty-two patients died during the follow-up period. Conclusion: External ventricular drainage is a system applied to reduce intracranial pressure under emergency conditions and has positive effects on clinical survival rate. Infection is the most common and most mortal complication. The drainage should only be applied in cases where it is absolutely necessary and in accordance with certain protocols. Furthermore, ventriculostomy should be kept only for the required period of time, and patients should be followed closely considering the exponential increase in infection after five days.

Anahtar Kelimeler

• External Ventricular Drainage System,ventriculitis,mortality

Kaynakça

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