Abstract

GARDELLA, Javier L.; GUEVARA, Martín; PURVES, Cynthia  and  MOUGHTY CUETO, Carolina. Monitoreo de presión intracraneana: infección y otras complicaciones con el uso de K-30^® subdural y fibra óptica intraparenquimatosa. Rev. argent. neurocir. [online]. 2006, vol.20, n.4, pp.151-155. ISSN 1850-1532.

Objective: To evaluate the complications between to types of intracranial pressure monitoring devices: subdural K-30^® (SK) and intraparenchymal fiber optic (FO). Method: In this descriptive retrospective study we reviewed the clinical records of those patients who were admitted to the Intensive Care Unit of the Hospital "Juan A. Fernández" (June 1993-February 2003) and required intracranial pressure monitoring. We processed the data with the STATA 6.0 programme. Results: We inserted 252 monitors in 191 patients: 71 FO and 181 SK; 188 were primary and 64 were secondary procedures. The causes of removal were: dislocation of the device, technical failure, neurological deterioration and permanence longer than 5 days. Dislocation occurred in 13 cases (12 SK, 1 FO), technical failure was observed in 33 cases (20 SK, 13 FO). We observed cerebrospinal fluid fistula (CSF) in 9 cases (7 SK , 2 FO). Only 1 case that presented with fistula had a positive CSF culture with a non typified germen. In 6 cases the change of the catheter was due to neurological deterioration. Changing due to permanence longer than 5 days occurred in 12 cases. The period of monitorization was 1-15 days (median: 3 days). The permanence of the catheter in non infected patients was 3.62±3.22 days and on infected patients was 4.67±2.30 days. On 29 cases we observed infection, 10 FO and 19 SK (NS p). It was not significant the difference between age, sex, Glasgow and surgery when related to infection and type of device. It was significant the rate of infection in patients that had to be reoperated. Conclusion: From a technical point of view monitorization of the intracranial pressure using SK proved to be reliable. In our experience the rate of complications between the SK was similar to those observed with FO.

Keywords : Intracranial pressure; Complications; Infection; Subdural catheter.

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