Optimal Timing of External Ventricular Drainage after Severe Traumatic Brain Injury: A Systematic Review

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ID: 115106
2020
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Abstract
External ventricular drainage (EVD) may be used for therapeutic cerebrospinal fluid (CSF) drainage to control intracranial pressure (ICP) after traumatic brain injury (TBI). However, there is currently uncertainty regarding the optimal timing for EVD insertion. This study aims to compare patient outcomes for patients with early and late EVD insertion. Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, MEDLINE/EMBASE/Scopus/Web of Science/Cochrane Central Register of Controlled Trials were searched for published literature involving at least 10 severe TBI (sTBI) patients from their inception date to December 2019. Outcomes assessed were mortality, functional outcome, ICP control, length of stay, therapy intensity level, and complications. Twenty-one studies comprising 4542 sTBI patients with an EVD were included; 19 of the studies included patients with an early EVD, and two studies had late EVD placements. The limited number of studies, small sample sizes, imbalance in baseline characteristics between the groups and poor methodological quality have limited the scope of our analysis. We present the descriptive statistics highlighting the current conflicting data and the overall lack of reliable research into the optimal timing of EVD. There is a clear need for high quality comparisons of early vs. late EVD insertion on patient outcomes in sTBI.
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chau2020journaloptimal Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Charlene Y. C. Chau;Saniya Mediratta;Mikel A. McKie;Barbara Gregson;Selma Tulu;Ari Ercole;Davi J. F. Solla;Wellingson S. Paiva;Peter J. Hutchinson;Angelos G. Kolias;Chau, Charlene Y. C.;Mediratta, Saniya;McKie, Mikel A.;Gregson, Barbara;Tulu, Selma;Ercole, Ari;Solla, Davi J. F.;Paiva, Wellingson S.;Hutchinson, Peter J.;Kolias, Angelos G.;
Journal journal of clinical medicine
Year 2020
DOI
10.3390/jcm9061996
URL
https://www.mdpi.com/2077-0383/9/6/1996
Keywords
icp intracranial pressure neurosurgery evd tbi ventriculostomy neurotrauma

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