Risultati della derivazione ventricolare esterna precoce nella dilatazione ventricolare postemorragica del neonato.

Translated title of the contribution: Results of early external ventricular diversion in posthemorrhagic ventricular dilatation in the newborn

M. L. Massone, A. Cama, D. Leone, E. Pellas, R. Vallarino, S. Carini, L. Andreussi

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE AND DESIGN. The authors report the outcome of early treatment with long-term external ventricular drainage (EVD) of progressive post-hemorrhagic ventricular dilatation (PPHVD), following peri-intraventricular hemorrhage (PIVH) in a population of preterm newborns. SETTING. Neonatal Intensive Care Unit (NICU) of a Children's Hospital. PATIENTS. Twenty-one preterms of 29.6 +/- 2.4 weeks of gestational age, weighing at birth 1443 +/- 445 g, mechanically ventilated, submitted to early EVD because of PPHVD following PIVH of III (n 11) e IV (n 10) grade. METHODS. PPHVD was diagnosed on the basis of US and TC findings. An external liquoral drainage suitable, for its technical characteristics, to be maintained for a long period of time and peculiar anesthesiologic, intra and postoperative treatments were utilized. RESULTS. EVD was placed at 21 +/- 5.8 days of life and maintained for 40 +/- 16 days. In all cases reduction of ventricular size was observed. One case (5%) developed liquoral infection and recovered with antibiotic therapy. No obstruction or dislocation of the ventricular catheter occurred. During EVD 3 patients (14%) died because of respiratory complications. After the normalization of cerebrospinal fluid (CSF), a "permeability test" was performed to assess the canalization of the liquoral system. Seven patients (33.5%) underwent ventriculo-peritoneal shunt (VPS) and 11 (52.5%) became shunt-free. CONCLUSIONS. Our results indicate that long-term use of EVD has a low risk of complications, avoids the need for transcutaneous tips and allows monitoring of CSF characteristics. Furthermore EVD protects the brain from liquoral hypertension, while waiting for a possible recurrence of natural CSF circulation, and is associated with a low number of definitive VPS.

Translated title of the contributionResults of early external ventricular diversion in posthemorrhagic ventricular dilatation in the newborn
Original languageItalian
Pages (from-to)663-668
Number of pages6
JournalMinerva Anestesiologica
Volume60
Issue number11
Publication statusPublished - Nov 1994

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Results of early external ventricular diversion in posthemorrhagic ventricular dilatation in the newborn'. Together they form a unique fingerprint.

Cite this