Background: The incidence of ICP monitoring has increased over the years and the indications for placement have expanded. Although ventriculostomy and ICP monitor placement are among the most commonly performed neurosurgical procedures, the current practice patterns have rarely been studied. Methods: A 10-question survey was sent to 2006 neurosurgeons and 1060 neurosurgery residents in the US. Demographic information and data regarding estimated success rates of ventriculostomies, the steps taken in failure and use of technological aids used was sought. Results: 479 neurosurgeons and 108 residents responded to our survey (response rates 23.9% and 10.2%, respectively). No catheter misplacements were reported by 19.8% respondents in the previous year whereas 2.2% reported misplacing more than 30%. With regards to ventriculostomy for patients with slit ventricles, image guidance was used by 51.7%; freehand technique was preferred by 41.6% and the Ghajar guide was used by 6.7% of respondents. We found that 56.9% of respondents abandoned free-hand placement after 3 failed passes. After abandoning free-hand cannulation, respondents used an ICP bolt or similar intra-parenchymal pressure monitoring device in trauma patients. Other approaches included leaving the catheter in place and readjusting it after repeating a CT scan. Conclusions: This survey sheds light on the current practice of ventriculostomy placement. Both residents and neurosurgeons admit to multiple attempts and frequent catheter misplacement. In order to consider a change in practice, respondents cited an increase in available data about guidance systems and ability to accommodate abnormal ventricular anatomy as primary requirements. A prospective study could help establish true evidence based practice for this common neurosurgical procedure. (C) 2011 Elsevier B.V. All rights reserved.
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Columbia Univ, Med Ctr, Dept Pediat Infect Dis, New York, NY 10032 USAColumbia Univ, Med Ctr, Dept Pediat Infect Dis, New York, NY 10032 USA
Gagliardo, Christina
Murray, Meghan
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Columbia Univ, Med Ctr, Dept Pediat, New York, NY 10032 USAColumbia Univ, Med Ctr, Dept Pediat Infect Dis, New York, NY 10032 USA
Murray, Meghan
Saiman, Lisa
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Columbia Univ, Med Ctr, Dept Pediat, New York, NY 10032 USA
New York Presbyterian Hosp, Dept Infect Prevent & Control, New York, NY USAColumbia Univ, Med Ctr, Dept Pediat Infect Dis, New York, NY 10032 USA
Saiman, Lisa
Neu, Natalie
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Columbia Univ, Med Ctr, Dept Pediat, New York, NY 10032 USAColumbia Univ, Med Ctr, Dept Pediat Infect Dis, New York, NY 10032 USA
机构:
Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Tufts Med Ctr, Floating Hosp Children, Boston, MA USA
Tufts Univ, Sch Med, Boston, MA 02111 USATufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Leslie, Laurel K.
Rodday, Angie Mae
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Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USATufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Rodday, Angie Mae
Saunders, Tully S.
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Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USATufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Saunders, Tully S.
Cohen, Joshua T.
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Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Tufts Univ, Sch Med, Boston, MA 02111 USATufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Cohen, Joshua T.
Wong, John B.
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Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Tufts Univ, Sch Med, Boston, MA 02111 USATufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Wong, John B.
Parsons, Susan K.
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Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA
Tufts Med Ctr, Floating Hosp Children, Boston, MA USA
Tufts Univ, Sch Med, Boston, MA 02111 USATufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA