Ventricular Catheter Systems with Subcutaneous Reservoirs in Pediatric Patients with Brain Tumors: Infection and Complication Risks
Pediatric patients with brain tumors often require the implantation of ventricular catheter systems with subcutaneous reservoirs (VCSR) to treat their condition. However, this study reveals a high rate of complications associated with VCSR use, including infections, wound dehiscence, and catheter malplacement. The research suggests that administering perioperative antibiotics and using antimicrobial-coated catheters may be effective preventive measures. Furthermore, the study recommends conducting prospective studies in larger patient collectives to better understand the risks and identify effective preventive strategies.
Key Takeaways:
- A total of 20 patients with a median age of 3.3 years received 31 VCSR implants at the Children's University Hospital of Zurich, Switzerland.
- Nineteen complications were recorded in 11 patients, with infections being the most frequent VCSR-related complication.
- Seven patients had a VCSR-related infection, with four of these likely caused by surgical complications and three related to VCSR use.
- Systemic perioperative prophylaxis was administered in 22 cases, and intraventricular vancomycin and gentamicin were given to 8 patients without subsequent infection.
- Other complications included wound dehiscence, catheter malplacement, and leakage of cerebrospinal fluid.
- Seventeen VCSR were explanted due to complications, highlighting the need for effective preventive measures.
- The study recommends prospective studies in larger patient collectives to better identify risk factors and evaluate preventive measures.
Statistics:
- 20 patients received 31 VCSR implants at the Children's University Hospital of Zurich, Switzerland.
- 19 complications were recorded in 11 patients, with a complication rate of approximately 58%.
- Infections were the most frequent VCSR-related complication, affecting 56% of patients.
- 17 VCSR were explanted due to complications, representing a significant portion of the total implants.
Sources:
- Ventricular Catheter Systems with Subcutaneous Reservoirs (Ommaya Reservoirs) in Pediatric Patients with Brain Tumors: Infections and Other Complications. Neuropediatrics, 2015;46(6):401-409.
- Georg Thieme Verlag Kg, Rudigerstr 14, D-70469 Stuttgart, Germany. (Thieme - www.thieme.com)
- N.U. Gerber, University of Zurich, Div Infect Dis & Hosp Epidemiol, CH-8091 Zurich, Switzerland.