Arts Sebastian, van Bilsen Martine, van Lindert Erik J, Bartels Ronald Hma, Aquarius Rene, Boogaarts Hieronymus D
Department of Neurosurgery, Radboud University Medical Center, 6525GA Nijmegen, The Netherlands.
Brain Sci. 2021 May 22;11(6):683. doi: 10.3390/brainsci11060683.
Automated cerebrospinal fluid (CSF) drainage systems allow for the mobilization of patients with an external CSF drain. The aim of this study is to describe the implementation of an automated CSF drainage system in neurosurgical patients with external CSF drains.
A feasibility study was performed using an automated CSF drainage system (LiquoGuard7, Möller Medical GmbH, Fulda, Germany) in adult neurosurgical patients treated with external lumbar or external ventricular drains between December 2017 and June 2020. Limited mobilization was allowed-patients were allowed to adjust their inclined beds, sit in chairs and walk under the supervision of a nurse or physical therapist. The primary outcome was the number of prematurely terminated drainage sessions.
Twenty-three patients were included. Drainage was terminated prematurely in eight (35%) patients. In three (13%) of these patients, drainage was terminated due to signs of hydrocephalus. Pressure-controlled drainage in patients with external lumbar drains (ELD) showed inaccurate pressure curves, which was solved by using volume-controlled drainage in ELD patients.
The implementation of an automated CSF drainage system (LiquoGuard7) for CSF drainage allows for early mobilization in a subset of patients with external CSF drains. External lumbar drains require volume-based drainage rather than differential pressure-dependent drainage.
自动脑脊液（CSF）引流系统可使带有外置CSF引流管的患者实现活动。本研究的目的是描述自动CSF引流系统在有外置CSF引流管的神经外科患者中的应用情况。
在2017年12月至2020年6月期间，对使用自动CSF引流系统（LiquoGuard7，德国富尔达的默勒医疗有限公司）治疗的成年神经外科患者进行了一项可行性研究，这些患者使用了外置腰大池引流管或外置脑室引流管。允许有限的活动——患者可在护士或物理治疗师的监督下调整病床倾斜度、坐在椅子上以及行走。主要结局是过早终止引流的次数。
纳入了23例患者。8例（35%）患者的引流过早终止。其中3例（13%）患者因脑积水迹象而终止引流。外置腰大池引流管（ELD）患者的压力控制引流显示压力曲线不准确，通过对ELD患者采用容量控制引流得以解决。
使用自动CSF引流系统（LiquoGuard7）进行CSF引流可使一部分有外置CSF引流管的患者早期活动。外置腰大池引流管需要基于容量的引流而非依赖压差的引流。
