Impact of Drain Column Height setting on Intracranial Pressure Control and Outcomes After Severe Traumatic Brain Injury: A Retrospective Study - 11/04/26
, Marie Werner b, Benjamin Cohen c, Vincent Legros d, Thomas Clavier e, Jean Pasqueron f, Caroline Jeantrelle g, Clément Gakuba a, h, Benoit Champigneulle iThe Traumabase Group
Highlights |
• | Lower initial EVD drainage height was not associated with improved ICP control. |
• | CSF drainage volumes and ICP trends were similar between low and high thresholds. |
• | Initial EVD height did not influence neurological outcome at ICU discharge. |
Abstract |
Background |
External ventricular drainage (EVD) is commonly used to control intracranial pressure (ICP) in severe traumatic brain injury (TBI). Although drainage column height is assumed to influence cerebrospinal fluid (CSF) diversion and ICP control, its clinical impact remains uncertain.
Methods |
We conducted a multicenter cohort study including patients with severe TBI requiring EVD placement across nine centers. Patients were categorized according to the initial drainage column height threshold (≤10 cmH 2 O vs. > 10 cmH 2 O). The primary outcome was ICP control, assessed by the highest daily ICP during the first two days after EVD insertion. Secondary outcomes included CSF drainage volume, escalation to third-tier therapies and neurological outcome at ICU discharge.
Results |
Among 145 patients with available drainage height data, 50 (34.5%) had an initial threshold ≤10 cmH 2 O. A lower drainage threshold was not associated with improved ICP control. EVD effectively prevented escalation in 25 patients (50%) of those with a drainage ≤10 cmH 2 O vs 46 patients (48%) with a drainage height > 10 cmH 2 O ( p = 0.90). The proportion of patients achieving a good outcome (GOS-E ≥4) at ICU discharge was similar (28% vs . 26%, p = 0.90) in both groups.
Conclusions |
In this multicenter cohort, a lower initial EVD drainage threshold was not associated with improved ICP control or neurological outcome in severe TBI.
Le texte complet de cet article est disponible en PDF.Keywords : Traumatic brain injury, External ventricular drain, Cerebrospinal fluid, Intracranial hypertension, Severe trauma
Plan
Vol 72 - N° 3
Article 101808- mai 2026 Retour au numéro
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