A review of external lumbar drainage for the management of intracranial hypertension in traumatic brain injury.

Autor: Ginalis EE; Department of Neurosurgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Department of Neurosurgery, Rutgers-New Jersey Medical School, Newark, NJ, USA. Electronic address: Elizabeth.Ginalis@rutgers.edu., Fernández LL; Faculty of Medicine, El Bosque University, Semillero Investigación Neurotrauma, Group of Investigation INUB-MEDITECH, Institute of Neuroscience and Neurosurgery, El Bosque University, Bogotá, Colombia., Ávila JP; School of Medicine and Health Sciences, Universidad del Rosario, Institute of Neuroscience and Neurosurgery, El Bosque University, Bogotá, Colombia., Aristizabal S; Faculty of Medicine, El Bosque University, Semillero Investigación Neurotrauma, Group of Investigation INUB-MEDITECH, Institute of Neuroscience and Neurosurgery, El Bosque University, Bogotá, Colombia., Rubiano AM; Institute of Neuroscience and Neurosurgery, El Bosque University, Bogotá, Colombia; MEDITECH Foundation, Cali Valle, Colombia.
Jazyk: angličtina
Zdroj: Neuro-Chirurgie [Neurochirurgie] 2022 Feb; Vol. 68 (2), pp. 206-211. Date of Electronic Publication: 2021 May 26.
DOI: 10.1016/j.neuchi.2021.05.004
Abstrakt: Background: The Brain Trauma Foundation (BTF) published evidence-based guidelines with a detailed approach to the management of intracranial hypertension (ICH) in traumatic brain injury (TBI) patients. However, management with cerebrospinal fluid (CSF) drainage in TBI patients remains a controversial topic and is a recent addition to the 4 th Edition of the BTF guidelines. External lumbar drainage (ELD) has been proposed for the management of patients with refractory ICH despite aggressive measures. ELD has been described in the literature with possible benefits in outcomes; still, many questions remain unanswered.
Methods: A systematic search on MEDLINE was conducted for articles that studied lumbar CSF drainage in adult TBI patients with ICH.
Results: Eleven studies met the inclusion criteria, which included 5 prospective and 6 retrospective studies. Several studies showed that CSF drainage via lumbar drain resulted in significant reduction of ICP compared to before ELD placement and had a low complication rate. However, the data reporting mortality and functional outcomes are varied across studies.
Conclusion: The literature suggests that ELD may play a role in the management of refractory ICH in TBI patients when first and second-tier measures fail and may be a safe, effective, and minimally invasive method to significantly lower ICP. Additional research and standardized treatment protocols are necessary.
(Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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