Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH, London, UK.
East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, Surrey, UK.
Acta Neurochir (Wien). 2023 Jun;165(6):1505-1509. doi: 10.1007/s00701-023-05503-y. Epub 2023 Jan 24.
The commonly used cerebrospinal fluid (CSF) drainage system remains the manual drip-chamber drain. The LiquoGuard (Möller Medical GmbH, Germany) is an automated CSF management device with dual functionality, measuring intracranial pressure and automatic pressure- or volume-led CSF drainage. There is limited research for comparison of devices, particularly in the neurosurgical field, where it has potential to reshape care.
This study aims to compare manual drip-chamber drain versus LiquoGuard system, by assessing accuracy of drainage, associated morbidity and impact on length of stay.
Inclusion criteria consisted of suspected normal pressure hydrocephalus (NPH) patients undergoing extended lumbar drainage. Patients were divided into manual drain group versus automated group.
Data was analysed from 42 patients: 31 in the manual group versus 11 in the LiquoGuard group. Volumetric over-drainage was seen in 90.3% (n = 28) versus 0% (p < 0.05), and under-drainage in 38.7% (n = 12) versus 0% (p < 0.05), in the manual and automatic group, respectively. Symptoms of over-drainage were noted in 54.8% (n = 17) of the manual group, all of which had episodes of volumetric over-drainage, versus 18.2% (n = 2) in automated group, of which neither had actual over-drainage (p < 0.05). Higher over-drainage symptoms of manual drain is likely due to increased fluctuation of CSF drainage, instead of smooth CSF drainage seen with LiquoGuard system. An increased length of stay was seen in 38.7% (n = 12) versus 9% (n = 1) (p < 0.05) in the manual and LiquoGuard group, respectively.
The LiquoGuard device is a more superior way of CSF drainage in suspected NPH patients, with reduced morbidity and length of stay.
常用的脑脊液（CSF）引流系统仍然是手动滴注瓶引流。LiquoGuard（德国 Möller Medical GmbH）是一种具有双重功能的自动 CSF 管理设备，可测量颅内压并进行自动压力或体积引导的 CSF 引流。目前，关于设备的比较研究有限，特别是在神经外科领域，该设备有可能改变治疗方式。
本研究旨在通过评估引流的准确性、相关发病率以及对住院时间的影响，比较手动滴注瓶引流与 LiquoGuard 系统。
纳入标准为疑似正常压力脑积水（NPH）患者行延长腰椎引流。患者分为手动引流组和自动引流组。
共分析了 42 例患者的数据：手动组 31 例，LiquoGuard 组 11 例。手动组有 90.3%（n=28）出现过度引流，而自动组无（p<0.05）；手动组有 38.7%（n=12）出现引流不足，而自动组无（p<0.05）。手动组有 54.8%（n=17）出现过度引流症状，均伴有容量过度引流，而自动组仅有 18.2%（n=2）出现过度引流症状，且均无实际过度引流（p<0.05）。手动引流的过度引流症状较高，可能是由于 CSF 引流波动增加，而不是像 LiquoGuard 系统那样平稳引流。手动组的住院时间延长发生率为 38.7%（n=12），而自动组为 9%（n=1）（p<0.05）。
LiquoGuard 装置是疑似 NPH 患者更优越的 CSF 引流方式，可降低发病率和住院时间。
