Abstract
Abstract
Background
Bacterial meningitis can cause a life-threatening increase in intracranial pressure (ICP). ICP-targeted treatment including an ICP monitoring device and external ventricular drainage (EVD) may improve outcomes but is also associated with the risk of complications. The frequency of use and complications related to ICP monitoring devices and EVDs among patients with bacterial meningitis remain unknown. We aimed to investigate the use of ICP monitoring devices and EVDs in patients with bacterial meningitis including frequency of increased ICP, drainage of cerebrospinal fluid (CSF), and complications associated with the insertion of ICP monitoring and external ventricular drain (EVD) in patients with bacterial meningitis.
Method
In a single-center prospective cohort study (2017–2021), we examined the frequency of use and complications of ICP-monitoring devices and EVDs in adult patients with bacterial meningitis.
Results
We identified 108 patients with bacterial meningitis admitted during the study period. Of these, 60 were admitted to the intensive care unit (ICU), and 47 received an intracranial device (only ICP monitoring device N = 16; EVD N = 31). An ICP > 20 mmHg was observed in 8 patients at insertion, and in 21 patients (44%) at any time in the ICU. Cerebrospinal fluid (CSF) was drained in 24 cases (51%). Severe complications (intracranial hemorrhage) related to the device occurred in two patients, but one had a relative contraindication to receiving a device.
Conclusions
Approximately half of the patients with bacterial meningitis needed intensive care and 47 had an intracranial device inserted. While some had conservatively correctable ICP, the majority needed CSF drainage. However, two patients experienced serious adverse events related to the device, potentially contributing to death. Our study highlights that the incremental value of ICP measurement and EVD in managing of bacterial meningitis requires further research.
Funder
The Research Fund of Copenhagen University Hospital - Rigshospitalet
National Hospital
Publisher
Springer Science and Business Media LLC
Reference22 articles.
1. (2021) Population in Denmark [Internet]. Statistics Denmark. [cited 2021 Jul 23]. Available from: https://www.dst.dk/en/Statistik/emner/befolkning-og-valg/befolkning-og-befolkningsfremskrivning/folketal
2. (2024) Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management. National Institute for Health and Care Excellence [Internet]. NG240. Available from: https://www.nice.org.uk/guidance/ng240
3. Abulhasan YB, Al-Jehani H, Valiquette MA, McManus A, Dolan-Cake M, Ayoub O et al (2013) Lumbar drainage for the treatment of severe bacterial meningitis. Neurocrit Care 19(2):199–205
4. Bodilsen J, Larsen L, Brandt CT, Wiese L, Hansen BR, Andersen CØ et al (2021) Existing data sources for clinical epidemiology: the Danish Study Group of Infections of the Brain Database (DASGIB). Clin Epidemiol 13:921–933
5. Dimitriou J, Levivier M, Gugliotta M (2016) Comparison of complications in patients receiving different types of intracranial pressure monitoring: a retrospective study in a single center in Switzerland. World Neurosurg 89:641–646
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献