EVD Infection (Ventriculitis): Diagnosis, Prevention & Treatment
External Ventricular Drainage (EVD) is a life-saving intervention for managing acute hydrocephalus and intracranial pressure. However, the most daunting complication in neuro-intensive care remains EVD infection (Ventriculitis). This nosocomial condition significantly increases patient morbidity and can compromise neurological recovery. Because an EVD catheter acts as a foreign body, it is naturally prone to bacterial colonization via transcutaneous or intraluminal routes.
Preventing EVD infection (Ventriculitis) requires a dual approach: strict adherence to aseptic protocols and the utilization of advanced biomaterial technologies. Desu Medical’s EVD-020 series, featuring antibiotic-impregnated catheters, is specifically designed to act as a primary defense mechanism, neutralizing pathogens before they can establish a foothold in the central nervous system.
Explore our EVD-020 antibiotic-coated solutions at desu.tr.
Identifying Signs and Symptoms of EVD-Associated Ventriculitis
Diagnosing infection in neurosurgical patients is often complicated by their baseline condition. Patients may be sedated or have altered consciousness, making traditional “stiff neck” symptoms difficult to detect. Key indicators of infection (Ventriculitis) include:
Unexplained Fever: While “central fever” is common in brain injuries, a sustained rise in temperature should always trigger an infectious workup.
CSF Turbidity: Infected cerebrospinal fluid often loses its “crystal clear” appearance, becoming cloudy or showing visible sedimentation.
Desu’s high-transparency drip chambers allow for early visual detection of these changes.
Neurological Deterioration: Any unexplained decline in the Glasgow Coma Scale (GCS) score may signal an underlying inflammatory response in the ventricles.
How Is Catheter-Related CNS Infection Diagnosed?
When suspicion arises, definitive diagnosis of infection (Ventriculitis) relies on meticulous CSF analysis. It is critical to differentiate between true infection and simple contamination.
Proximal Sampling: Samples should never be taken from the drainage bag. Desu EVD sets feature specialized proximal sampling ports to ensure fresh, uncontaminated CSF is drawn directly from the catheter.
Biochemical Markers: Key indicators include pleocytosis (elevated white blood cell count), significantly high protein levels, and elevated lactate.
The Glucose Ratio: A CSF-to-blood glucose ratio of less than 0.4 (hypoglycorrhachia) is a strong indicator of bacterial consumption and active infection.
Prevention Strategies: Sterile Technique and Biomaterials
Prophylaxis is the most effective way to combat infection (Ventriculitis). This begins in the operating room and continues through daily ICU maintenance.
Maximum Sterile Barriers: Insertion must occur under full surgical conditions (sterile gown, drapes, and masks).
Subcutaneous Tunneling: Creating a long tunnel (at least 5 cm) between the skull entry and skin exit point creates a physical barrier that bacteria must traverse to reach the brain.
Desu EVD-020 Technology: The gold standard in prevention is the use of antibiotic-coated catheters. The Desu EVD-020 series is impregnated with Rifampicin and Clindamycin. Once in contact with CSF, these antibiotics are released in a controlled manner, creating a “zone of inhibition” that prevents biofilm formation for up to 28 days.
Clinical Treatment Protocols for Bacterial Ventriculitis
If infection (Ventriculitis) is confirmed, immediate and aggressive management is necessary to clear the pathogen and protect the brain parenchyma.
Targeted Antibiotic Therapy: Initiating systemic antibiotics that can cross the blood-brain barrier is the first step. In some cases, intrathecal antibiotics are administered directly through the Desu system’s reservoir.
Catheter Exchange: Biofilm-protected bacteria on an infected catheter are often resistant to systemic drugs. The infected must be removed and replaced, ideally at a new site.
Re-implantation Safety: During the exchange, using a Desu EVD-020 antibiotic-coated catheter is highly recommended to prevent immediate re-colonization in an already infectious environment.
Conclusion: Empowering Clinicians Against Ventriculitis
Effective management of infection (Ventriculitis) moves beyond reactive treatment into the realm of proactive prevention. By integrating strict aseptic care with the pharmacological protection of the Desu EVD-020 series, neurosurgical teams can significantly reduce infection rates and improve patient outcomes.
Would you like to review the clinical studies on the zone of inhibition provided by our Rifampicin-Clindamycin coated catheters? For technical specifications and ordering information, visit desu.tr. Trust Desu to protect your most vulnerable patients.
Turkish