Metal external ventricular drainage catheters in the treatment of persistent ventriculitis - an old story made new: Technical note and preliminary results

Abstract

AIM: Conventional ventricular catheters have proven to be ineffective in the drainage of the cerebrospinal fluid in the long run in terms of infection rates. Consequently, the development and clinical evaluation of new catheters is urgently needed. Ma terIal and Methods: We implanted a ventricular needle made of stainless steel in 3 neurosurgical patients in whom multiple conventional (silicon) ventricular catheters had been previously implanted. All of them developed persistent ventriculitis during the first 30 days post-admission. The infection did not respond to antibiotics neither intravenously nor intrathecally via conventional catheters. After the implantation of the needle, colistin mesilate sodium was administered (150,000IU/day for 21 days) intrathecally, cerebrospinal fluid white blood cells were measured and cerebrospinal fluid cultures were obtained. Results: Within 15 days after the implantation of the metal catheter, a significant decrease of the cerebrospinal fluid white blood cell count was noted and all cultures were negative. No operation related complications were observed. ConclusIon: Our technique of a metal catheter implantation is safe and requires fewer reoperations. Moreover, it is cost-effective since metal catheters can be used for longer periods of time, can be reused in other patients, and are of low cost.