Neuroanesthesia & neurocritical care
Impact of lumbar cerebrospinal fluid drainage to control intracranial hypertension in patients with severe traumatic brain injury: a retrospective monocentric cohort
Main finding · IH durationResult — go to the resultHazard ratio 1.74 95% CI 1.05–2.87Authors' conclusion
ELD appears in our cohort to be a safe and effective strategy to control post-traumatic IH, with an acceptable benefit-risk ratio.
Study context
- Population
- TBI patients with intracranial hypertension (≥ 22 mmHg despite optimal sedation), regional Level-I trauma centre critical care unit, 2012–2022analysed
- Participants
- Ninety patients
- Exposure
- External lumbar drainage vs no external lumbar drainage (ELD)
- ELDn = 50
- Outcome
- Duration of intracranial hypertension
Methodological detailsmonocentric, multivariable Cox regression, multivariable logistic regression
- Monocentric
- Multivariable Cox regression
- Multivariable logistic regression
Main finding
IH duration
Hazard ratio
1.74
95% CI 1.05–2.87
P = 0.03
ELD vs no ELD
HR 1.74 (95% CI 1.05–2.87); P = 0.03
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Unfavourable outcome (6-month GOS 1-3) · multivariable logistic regression | 0.32 (0.13–0.77) | P = 0.011 | |
| 0.10.31310Odds ratio (log scale) |
Safety
ELD complications
- Cerebral herniation following ELD placement
- 1 (2%)
- Device-associated meningitis
- 2 (4%)
Original publication
Impact of lumbar cerebrospinal fluid drainage to control intracranial hypertension in patients with severe traumatic brain injury: a retrospective monocentric cohort. Crit Care. Published 2 January 2025. doi:10.
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