Lee Hanna, Yang Boeun, Lee Kyeongeun, Han Jeongwon
Department of Nursing, Gangneung-Wonju National University, Wonju 25457, Republic of Korea.
College of Nursing Science, Kyung Hee University, Seoul 02447, Republic of Korea.
Healthcare (Basel). 2025 Apr 27;13(9):1009. doi: 10.3390/healthcare13091009.
The purpose of this study is to provide foundational data for nursing care in patients with external ventricular drainage (EVD) by comparatively analyzing drainage volume in relation to intracranial pressure (ICP) and drainage catheter size. In this study, we conducted a volumetric analysis using the continuity and Bernoulli equations, considering friction forces under predefined conditions. In adults in the supine position with 37 °C CSF, the ventricular drainage volume was assessed based on the height of the EVD system, ICP levels, and EVD catheter sizes. The results indicated that the CSF flow rate increased with larger catheter diameters and when the EVD system was positioned lower than the reference point (foramen of Monro). Across all catheter sizes, the minimum CSF flow occurred when the EVD system was 15 cm above the reference point, while the maximum flow was observed when it was 15 cm below the reference point. This multidisciplinary study, utilizing fluid dynamics, quantitatively estimates the drainage volume in EVD systems based on ICP and catheter size, contributing to the nursing care of EVD systems. The findings underscore the importance of developing specific nursing guidelines to improve patient safety in external ventricular drainage management and incorporating them into clinical education. A limitation of this study is that it does not compare with patients in clinical settings for clinical empirical validity. Therefore, a stepwise validation process is necessary. So, future studies will need to compare medical record data with the results of this study to confirm the validity of the equations presented.
本研究的目的是通过比较分析与颅内压（ICP）和引流导管尺寸相关的引流量，为脑室外引流（EVD）患者的护理提供基础数据。在本研究中，我们使用连续性方程和伯努利方程进行体积分析，同时考虑了预定义条件下的摩擦力。在体温为37°C的仰卧位成人中，根据EVD系统的高度、ICP水平和EVD导管尺寸评估脑室引流量。结果表明，导管直径越大，且EVD系统位置低于参考点（Monro孔）时，脑脊液流速增加。在所有导管尺寸中，当EVD系统高于参考点15 cm时脑脊液流速最小，而当低于参考点15 cm时流速最大。这项多学科研究利用流体动力学，基于ICP和导管尺寸定量估计EVD系统中的引流量，有助于EVD系统的护理。研究结果强调了制定具体护理指南以提高脑室外引流管理中患者安全性并将其纳入临床教育的重要性。本研究的一个局限性是未与临床环境中的患者进行比较以验证临床经验。因此，有必要进行逐步验证过程。所以，未来的研究需要将病历数据与本研究结果进行比较，以确认所提出方程的有效性。
