Hydrogel-coated ventricular catheters for high-risk patients receiving ventricular peritoneum shunt

Medicine (Baltimore). 2016 Jul;95(29):e4252. doi: 10.1097/MD.0000000000004252.

Abstract

Shunt infection is a morbid complication of cerebrospinal fluid (CSF) shunting. The catheters with a hydrophilic surface may impede bacterial adherence and thereby reduce catheter-related CSF infection.A retrospective study compared the occurrence of CSF infection related to use of either standard silastic catheters or hydrogel-coated ventricular catheters (Bioglide, Medtronic). The enrolment was available to neurosurgery patients undergoing shunt surgery from October 2012 to 2015 in two centers. The follow-up period was more than months.A total of 78 patients were included in the study. In 33 patients 35-cm hydrogel-coated ventricular peritoneum shunts (VPS) were used, and in remaining 45 patients 35-cm standard silastic VPS catheters were used. Infection occurred in 14 (17.9%) patients, including definite VPS-related CSF infection in 6 patients (7.7%) and probable infection in remaining 8 patients (10.3%). There was a significant difference found in patients with total infection between the two groups [RR (95% CI); 0.200 (0.050-0.803), P = 0.014]. Analysis of Kaplan-Meier curve estimates indicated significant statistical difference between the two catheter types in duration (log rank = 4.204, P < 0.05). Significant statistical differences were also found in the subgroups including previous CSF infection within 1 month (log rank = 4.391, P = 0.04), conversion of external ventricular drains to shunt (Log Rank = 4.520, P = 0.03), and hospital stay >1 month (log rank = 5.252, P = 0.02). There was no difference found between the two groups of the patients with other infections within 1 month. The follow-up period was of 36 months.The hydrogel-coated catheter is a safe and related to lower infection rates for high-risk patients who underwent shunt surgery.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antibiotic Prophylaxis
  • Bacterial Infections / prevention & control*
  • Catheter-Related Infections / prevention & control*
  • Coated Materials, Biocompatible*
  • Cross Infection / prevention & control*
  • Dimethylpolysiloxanes*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / surgery*
  • Hydrogel, Polyethylene Glycol Dimethacrylate*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk
  • Ventriculoperitoneal Shunt / instrumentation*

Substances

  • Coated Materials, Biocompatible
  • Dimethylpolysiloxanes
  • Hydrogel, Polyethylene Glycol Dimethacrylate
  • baysilon