This observational study involving patients with acute brain injury undergoing treatment with an external ventricular drain consists of three subprojects, aiming to: 1. investigate various biomarkers, with a primary focus on the development of cerebrospinal fluid lactate in relation to ventriculostomy-associated infection; 2. compare proximal and distal sample results obtained from an external ventricular drain; 3. describe the natural progression of various biomarkers in blood and cerebrospinal fluid following acute brain injury.
Study Type
OBSERVATIONAL
Enrollment
148
As soon as possible after placement of the external drain, and then in intervals of 1-3 days; * CSF analyses: cerebrospinal fluid group analysis (eosinophilic granulocytes, erythrocytes, glucose, nucleated cells, leucocytes (mononuclear), lymphocytes, macrophages, monocytes, neutrophil granulocytes, protein, and smudge cells) and lactate (L-lactate and D-lactate). Analyses will be performed by the Dept. of Biochemistry, Rigshospitalet, Denmark. * CSF microscopy and culture: Analysed by the Dept. of Microbiology, Rigshospitalet, Denmark. * Blood: C-reactive protein, differentials (leukocytes, neutrophile granulocytes, erythrocytes, lymphocytes). Analyses will be performed by the Dept. of Biochemistry, Rigshospitalet, Denmark. * Blood: lactate and glucose. Point of care (POC) analysis by blood gas analyser (Radiometer ABL800 Series Flex Q, Denmark)
Rigshospitalet
Copenhagen, Denmark
RECRUITINGConcentration of cerebrospinal fluid lactate
in patients with compared to patients without positive CSF culture, and for b. patients with both a positive CSF culture and a distinct drop in the level of consciousness compared to patients with negative CSF culture and a stable level of consciousness.
Time frame: Throughout the external ventricular drain duration (1-60 days)
CSF lactate concentration change in patients developing ventriculostomy associated infection
Concentration of CSF lactate and other CSF markers a. before, during and after detection of organisms in patients with a positive CSF culture, and b. if no organisms are detected, during the first, second and third tertile of EVD treatment.
Time frame: Throughout the external ventricular drain duration (1-60 days)
Functional outcome at six months
Functional outcome evaluated six months after the initial brain injury using: 1\) modified Rankin Scale (mRS) as favourable (0-2) or unfavourable (3-6)
Time frame: 6 months after the initial brain injury
Functional outcome at six months
Functional outcome evaluated six months after the initial brain injury using: 2\) Glascow Outcome Score-Extended (GOS-E) as favorable (5-8) or unfavorable (0-4)
Time frame: 6 months after the initial brain injury
Comparison of concentration of cerebrospinal fluid markers drawn from the proximal and distal port of the EVD
Mean difference, limits of agreement, intraclass correlation, mean of absolute difference and consistency between measurements of CSF markers drawn from the proximal and distal port of the EVD.
Time frame: Throughout the external ventricular drain duration (1-60 days)
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