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International Multicenter Survey of Perioperative Management of External Ventricular Drains: Results of the EVD Aware Study.

TitleInternational Multicenter Survey of Perioperative Management of External Ventricular Drains: Results of the EVD Aware Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsLele AV, Mills B, Qiu Q, Schloemerkemper N, Naik BIshwarlal, Williams J, Venkat-Raghavan L, Vavilala MS
Corporate AuthorsEVD Aware Study Collaborators
JournalJ Neurosurg Anesthesiol
Date Published2019 02 11
ISSN1537-1921
Abstract

INTRODUCTION: The perioperative management of patients with external ventricular drains (EVDs) is not well defined, and adherence to published management guidelines unknown. This study investigates practice, patterns, and variability in the perioperative management of patients with EVDs.

METHODS: A 31-question survey was sent to 1830 anesthesiologists from 27 institutions in North America, Europe, and Asia. A perioperative EVD Guideline Adherence Score was calculated for the preoperative, transport and intraoperative periods. Differences in management practices between neuroanesthesiologists and non-neuroanesthesiologists, and factors affecting EVD guideline adherence, were examined using bivariate significance tests and linear regression.

RESULTS: Among a sample of 599 anesthesiologists (survey response rate, 32.7%), compared with non-neuroanesthesiologists, neuroanesthesiologists were more likely to include baseline neurological examination (P=0.023), hourly cerebrospinal fluid output (P=0.006) and color (P<0.001), intracranial pressure trends (P<0.001), and EVD clamp trial (P<0.001) data in their routine preanesthetic assessment of patients with EVDs. There was a low prevalence of routine intracranial pressure monitoring during patient transport of patients with EVDs (14.4%). Overall, 25.9% of respondents were aware of EVD guidelines, and 21% reported receiving formal training in EVD management. The EVD Guideline Adherence Score was highest among anesthesiologists who reported being very comfortable in managing patients with EVDs compared with those who reported being uncomfortable (9.93 vs. 6.93, P<0.001).

CONCLUSIONS: The EVD Aware study identifies opportunities for improvement in the perioperative management of patients with EVDS, including global awareness, formal EVD training, and dissemination of educational tools.

DOI10.1097/ANA.0000000000000580
Alternate JournalJ Neurosurg Anesthesiol
PubMed ID30893282