To Connect Catheter To Drainage System; Complications; Infections; Overdrainage - Sophysa DE-106 Notice D'emploi

5. Adjust catheter length by cutting it close to its exit
point.
6. Clamp the catheter.
F 4 - V
IGURE ENTRICULAR CATHETER TUNNELIZATION
6.1.4. Luer connector fixation
Luer-lock connecting fitting use:
Insert Luer connector into the distal tip of the catheter and
suture it to the catheter (Cf Figure 5).
F 5 - L -
IGURE UER LOCK CONNECTING FITTING USE
PRECAUTION:
A double suture tie should be used to secure the ventricle
catheter fixation to the connecting fitting. Check to ensure
that the connection is tight prior to use. Do not tie ligatures
too tightly or use non metallic ligatures since silicone
elastomer is easily cut.
The catheter is fixed to the scalp using the fixation tab.
6.2. TO CONNECT CATHETER TO DRAINAGE
SYSTEM
WARNINGS:
Read all instructions,
mentionned in drainage system instructions for use, prior to
connect catheter to drainage system.
Ensure that the drainage system patient line is equiped with
a luer connector.
In order to ensure against ventricular collapse and the
possible consequence of tentorial herniation, always
perform a drainage set up against a positive pressure head
on the order of 20 cm H20 or 15 mm Hg.
PRECAUTION:
Ensure flow of CSF from the distal end of the shunt system
prior to closure.
.
.
precautions and warnings
After the catheter has been properly placed and the Luer
connector fixed into the distal tip of the catheter :
— Ensure the ventricular catheter is clamped at the exit
site to allow only a minimal amount of CSF to escape
during connector insertion and connection to system,
— Remove the end plug from the patient line,
— Attach the Luer connector to the patient line,
— After ensuring there is no bubbles in the patient line set
the patient line stopcock in the drain only position and
remove the clamp from the catheter.
WARNINGS:
Prior to use the drainage system :
— Read all instructions, precautions and warnings
mentionned in its instructions for use.
— Ensure there is no leak on the tubing and at the
connection between the drainage catheter and the
drainage system.

7. Complications

There are three main complications associated with CSF
external drainage system.

7.1. INFECTIONS

One major complication associated with ICP monitoring
with a ventricular or lumbar catheter is the risk of
infections, particulary meningitis and ventriculitis. The
incidence of these infections can be reduced by care in
inserting the catheter and stabilizing it:
— by passing it through a subgaleal (ventricular catheter)
or subcutaneous (lumbar catheter) tunnel before it
emerges;
— by fixing it to the scalp (ventricular catheter) or
cutaneous tissue (lumbar catheter) with the fixation tab.
Wound infections may occur but usually subside when the
catheter is removed.
Limiting the duration of monitoring from a single site to less
than five days will reduce the infection rate. If monitoring
must continue past five days, consider inserting a new
catheter at a fresh site and changing the entire system.
In case of infection, the drainage system shoud be
removed and specific treatment by general or intrathecal
routes should be introduced.

7.2. OVERDRAINAGE

A second major complication associated with ventricular or
lumbar drainage of CSF is overdrainage, which can lead
to intracranial hemorrhage and permanent neurological
deficit. Overdrainage can occur due to improper system
testing or setup (resulting in system leakage or
inappropriate system pressure head heights).

7.3. OBSTRUCTION

A third major complication associated with ventricular or
lumbar drainage of CSF is obstruction. Poor recording of
ICP will result if the catheter, patient line or other
components of the monitoring system become clogged
with blood clots, brain tissue fragments, or fibrinous debris.
ENGLISH – 5