Publication
Title
Ventricular drainage catheters versus intracranial parenchymal catheters for intracranial pressure monitoring-based management of traumatic brain injury : a systematic review and meta-analysis
Author
Abstract
Intracranial pressure (ICP) monitoring is one of the mainstays in the treatment of severe traumatic brain injury (TBI), but different approaches to monitoring exist. The aim of this systematic review and meta-analysis is to compare the effectiveness and complication rate of ventricular drainage (VD) versus intracranial parenchymal (IP) catheters to monitor and treat raised ICP in patients with TBI. Pubmed, Embase, Web of Science, Google Scholar, and the Cochrane Database were searched for articles comparing ICP monitoring-based management with VDs and monitoring with IP monitors through March 2018. Study selection, data extraction, and quality assessment were performed independently by two authors. Outcomes assessed were mortality, functional outcome, need for decompressive craniectomy, length of stay, overall complications, such as infections, and hemorrhage. Pooled effect estimates were calculated with random effects models and expressed as relative risk (RR) for dichotomous outcomes and mean difference (MD) for ordinal outcomes, with corresponding 95% confidence intervals (CI). Six studies were included: one randomized controlled trial and five observational cohort studies. Three studies reported mortality, functional outcome, and the need for a surgical decompression, and three only reported complications. The quality of the studies was rated as poor, with critical or serious risk of bias. The pooled analysis did not show a statistically significant difference in mortality (RR=0.90, 95% CI=0.60-1.36, p=0.41) or functional outcome (MD=0.23, 95% CI=0.67-1.13, p=0.61). The complication rate of VDs was higher (RR=2.56, 95% CI=1.17-5.61, p=0.02), and consisted mainly of infectious complications; that is, meningitis. VDs caused more complications, particularly more infections, but there was no difference in mortality or functional outcome between the two monitoring modalities. However, the studies had a high risk of bias. A need exists for high quality comparisons of VDs versus IP monitor-based management strategies on patient outcomes.
Language
English
Source (journal)
Journal of neurotrauma. - New York
Publication
New rochelle : Mary ann liebert, inc , 2019
ISSN
1557-9042 [online]
0897-7151 [print]
Volume/pages
36 :7 (2019) , p. 988-995
ISI
000448647800001
Pubmed ID
30251919
Full text (Publisher's DOI)
Full text (open access)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Project info
CENTER-TBI: Collaborative European NeuroTrauma Effectiveness Research in TBI
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 10.12.2018
Last edited 21.10.2021
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