External ventricular drains: Management and complications.
External ventricular drains: Management and complications.
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DOI：
10.4103/2152-7806.157620
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发表时间：
2015
影响因子：
--
通讯作者：
Muralidharan R
中科院分区：
文献类型：
--
作者：
Muralidharan R
体外脑室引流（EVD）的插入可以说是神经重症监护病房中最常见和最重要的救生程序之一。各种形式的急性脑损伤受益于EVD提供的连续颅内压（ICP）监测和脑脊液（CSF）分流。插入后，EVD监测、维护和故障排除基本上成为护理责任。从PubMed电子数据库中识别出与EVD置入、管理和并发症相关的文章。通常由神经外科医生或神经重症监护医师在紧急情况下使用表面标志放置在床边，该手术能够引流血液和CSF以缓解颅内高压，持续监测颅内压并滴注药物。护理应确保EVD收集系统的正确归零、放置、无菌性和完整性。颅内压波形分析和脑脊液引流的密切监测非常重要，可影响患者的临床结局。在某些机构，护理人员还可能负责CSF采样和导管冲洗。EVD相关并发症的维护、故障排除和监测基本上已成为护理职责。准确和负责任的护理可能有能力预示着更好的结果，病人需要脑脊液引流。
Insertion of an External Ventricular Drain (EVD) is arguably one of the most common and important lifesaving procedures in neurologic intensive care unit. Various forms of acute brain injury benefit from the continuous intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) diversion provided by an EVD. After insertion, EVD monitoring, maintenance and troubleshooting essentially become a nursing responsibility. Articles pertaining to EVD placement, management, and complications were identified from PubMed electronic database. Typically placed at the bedside by a neurosurgeon or neurointensivist using surface landmarks under emergent conditions, this procedure has the ability to drain blood and CSF to mitigate intracranial hypertension, continuously monitor intracranial pressure, and instill medications. Nursing should ensure proper zeroing, placement, sterility, and integrity of the EVD collecting system. ICP waveform analysis and close monitoring of CSF drainage are extremely important and can affect clinical outcomes of patients. In some institutions, nursing may also be responsible for CSF sampling and catheter irrigation. Maintenance, troubleshooting, and monitoring for EVD associated complications has essentially become a nursing responsibility. Accurate and accountable nursing care may have the ability to portend better outcomes in patients requiring CSF drainage.