Ventricular Catheter Systems with Subcutaneous Reservoirs in Pediatric Patients with Brain Tumors: Infection and Complication Risks

Strategic Insights -

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.