• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.7.2006.tde-03102006-104624
Document
Author
Full name
Silvia Rocha Cangussú
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Chaves, Eliane Correa (President)
Andrade, Almir Ferreira de
Lacerda, Rubia Aparecida
Title in Portuguese
Infecção na monitoração intraventricular da pressão intracraniana com drenagem contínua do líquido cefalorraquiano.
Keywords in Portuguese
Epidemiologia
Fatores de risco
Infecção
Monitoração da pressão intracraniana
Procedimentos neurocirúrgicos
Ventriculite
Ventriculostomia
Abstract in Portuguese
A monitoração intraventricular da pressão intracraniana (PIC) com drenagem contínua do líquido cefalorraquiano (LCR) já é um procedimento difundido na prática da neurocirurgia e considerado de grande importância diagnóstica, terapêutica e prognóstica por sua precisão. Entretanto, por se tratar de um método invasivo, apresenta riscos potenciais de complicações, sendo a infecção a mais freqüente. O presente estudo teve como objetivo verificar e analisar as taxas de infecções decorrentes deste método de monitoração da PIC, assim como as taxas de seus fatores de risco. As informações obtidas através de prontuários e arquivo dos exames laboratoriais foram registradas em duas fichas de coleta de dados próprias e posteriormente submetidas a testes estatísticos como o de Kruskal-Wallis, de Mann-Whitney, de qui-quadrado, teste exato de Fisher e o coeficiente de correlação de Spearman. Obtidas as freqüências relativas e absolutas, médias e desvio-padrão, sendo de 5% o nível de significância utilizado para os testes. A população deste estudo foi de 79 pacientes dos quais 70.9% eram do sexo masculino com média de 33.7 anos, sendo que os diagnósticos presentes em 82.3% eram referentes ao trauma craniencefálico (TCE) seguido de tumores intracranianos e acidentes vasculares cerebrais (AVCs). Todos fizeram uso de antibioticoprofilaxia. A taxa de ventriculite foi de 26.6%, permanecendo o cateter, em média, 6.7 dias e apresentando taxas diárias desta infecção variáveis. Não encontramos associação estatisticamente significativa entre tempo de monitoramento e infecção, porém houve um aumento no índice diário de ventriculite após os três primeiros dias e picos no 6°, 9° e 12° dia indicando uma provável ligação não acumulativa ou linear. Outras variáveis avaliadas neste estudo que apresentaram associação direta com a ocorrência de ventriculite foram o sexo masculino, hemorragia subdural e infecções em outros sítios, principalmente a sepses. Variáveis como idade, procedimentos invasivos, TCE aberto, fístulas liquóricas, hemorragia intraventricular, múltiplas ventriculostomias, presença de PIC acima de 20mmHg, intercorrências durante a cateterização ou manutenção desta não apresentaram associação com a taxa ventriculite, no entanto muitas destas variáveis estiveram presentes em poucos casos dificultando uma conclusão definitiva.
Title in English
Infection in the intraventricular monitoring of the intracranial pressure with continuous drainage of cerebrospinal fluid.
Keywords in English
Epidemiology
Infection
Intracranial pressure monitoring
Neurosurgical procedures
Risk factors
Ventriculitis
Ventriculostomy
Abstract in English
Intraventricular monitoring of the intracranial pressure (ICP) with continuous drainage of cerebrospinal fluid (CSF) is already a widespread procedure in neurosurgical practice and considered as of great diagnostic, therapeutic and prognostic importance due to its precision. However, as it is an invasive method, it presents a potential risk of complications, the infection being the most frequent. The present study aims at verifying and analyzing the rates of infection originating from this monitoring method of ICP, as well as the rates of its risk factors. The information obtained from case histories and laboratory test files were recorded on two own separate data collection cards and later submitted to statistical tests like the Kruskal-Wallis, Mann-Whitney, Chi-Square, Fisher’s exact test, and Spearman correlation coefficients. Relative and absolute, average and standard deviation frequency were verified, 5% was the significance level utilized for the tests. The population of this study was of 79 patients, 70.9% of which were male averaging 37.7 years of age, this being so that the diagnostics present in 82.3% are related to traumatic head injury followed by intracranial tumors and stroke. All of them made use of antibioticprophylaxis. The ventriculitis rate was of 26.6 %, the catheter remaining, on average, 6.7 days and showing variable daily rates of this infection. We have not found a statistically meaningful association between monitoring time and infection, however there was an increase in the daily ventriculitis rate after the first three days and peaks on the 6th, 9th and 12th days showing a probable non-cumulative or linear link. Other variables evaluated in this study which presented a direct association with the occurrence of ventriculitis were the male sex, subdural hemorrhage and infections at other sites, mainly sepsis. Variables such as age, invasive procedures, open traumatic head injury, CSF leaks, intraventricular hemorrhage, multiple ventriculostomies, presence of ICP above 20mmHg, intercurrences during catheterization or its maintenance did not show association with the ventriculitis rate, nevertheless many of these variables were present in few cases making a definite conclusion difficult.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Silvia_Cangussu.pdf (869.11 Kbytes)
Publishing Date
2006-11-17
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.