Neuroanesthesia & neurocritical care
Weaning from external ventricular drainage after non-traumatic subarachnoid hemorrhage: Rapid vs. gradual weaning and predicting closure trial failure. The SEVDVE retrospective multicenter cohort study
Authors' conclusion
Rapid weaning was associated with a high risk of closure trial failure, but shorter LOS. EVD closure trial failure was associated with worse outcomes.
Study context
- Population
- Adults hospitalized for subarachnoid hemorrhage (SAH) with an external ventricular drainage (EVD) and at least one EVD weaning attempt, 2018–2022of 1141 with an EVD
- Participants
- 407 adults
- Exposure
- Rapid vs gradual EVD weaning
- Rapidn = 158
- Gradualn = 249reference
- Outcome
- EVD closure trial failure
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
P = 0.044
Observational data: associations, not effects.
Further findings
ICU and hospital length of stay (LOS)
- Shorter ICU and hospital LOS with rapid weaning
Outcomes associated with closure trial failure
- Prolonged EVD maintenance
- P < 0.001
- Prolonged ICU LOS
- P = 0.001
- Prolonged hospital LOS
- P = 0.05
- Independently associated
Failure closure score (ICP difference H0 to H3 after closure, time since EVD insertion, EVD level)
- AUC
- 0.63 [0.53-0.74]
- Fair discrimination ability
- Testing set (1/3)
Original publication
Weaning from external ventricular drainage after non-traumatic subarachnoid hemorrhage: Rapid vs. gradual weaning and predicting closure trial failure. The SEVDVE retrospective multicenter cohort study. Anaesth Crit Care Pain Med. Published 15 March 2025. doi:10.
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