Drenaje lumbar externo con bomba volumétrica continua en pacientes con fístula cefalorraquídea. Series de casos / External lumbar drainage with volumetric continuing infusion pump in patients with cerebrospinal fluid leak. A case series

OBJETIVO: Describir las incidencias y complicaciones surgidas en una serie de casos de pacientes con fístula cefalorraquídea tratados mediante drenaje lumbar externo con bomba de infusión (BI) volumétrica continua desde el año 2001 al 2014. Cuantificar las fistulas cefalorraquídeas cerradas mediante drenaje lumbar externo con BI. MÉTODO: Estudio descriptivo retrospectivo de serie de casos. Población: pacientes intervenidos de cirugía hipofisaria transesfenoidal, Chiari y laminectomía, que desarrollaron en el postoperatorio fístula de líquido cefalorraquídeo tratada con drenaje lumbar externo continuo mediante BI. Variables: edad, sexo, tipo de intervención, variables relacionadas con el funcionamiento de la BI y relacionadas con complicaciones. Se calcularon medias y medianas para las variables cuantitativas y frecuencias y porcentajes para las cualitativas. RESULTADOS: La muestra incluyó 11 sujetos. Incidencias en el funcionamiento de la BI: desconexión, oclusión y activación de la alarma acústica de la bomba. La complicación más frecuente fue cefalea; hubo un caso de neumoencéfalo. DISCUSIÓN: El escaso número de sujetos y su heterogeneidad no permiten comparar ni establecer asociaciones entre variables. La resolución de la fístula de líquido cefalorraquídeo con BI continua es menor en este estudio que en otros revisados, pudiendo estar influido por el tamaño de la muestra. Destaca la frecuente activación de la alarma de la BI, sin causa aparente. Implicaciones para la práctica: Desarrollar un protocolo para preparar el equipo de la BI, que disminuya la activación de la alarma acústica. Realizar un estudio prospectivo multicéntrico

OBJECTIVE: To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. METHODS: Retrospective descriptive case series study. Population: patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP. Variables: age, sex, type of intervention, variables related to the practice of the pump and complications. Average and medians were calculated for quantitative variables, frequencies and percentages for qualitative. RESULTS: Sample: 11 subjects. Incidence in running IP: disconnection, occlusion and acoustic alarm activation. Most frequently complication is headache; a case of pneumocephalus. DISCUSSION: The small number of subjects and the heterogeneity of these do not allow for comparison or establishing associations between variables. The resolution of the cerebrospinal fluid leak with continuous IP is lower in this study than others, and may be influenced by the small number of subjects. It should be noted the frequent activation of the pump alarm for no apparent cause. Implications for practice: Protocol would be developed for preparing the IP team to reduce the acoustic alarm activation, and would make a prospective multicenter study

[External lumbar drainage with volumetric continuing infusion pump in patients with cerebrospinal fluid leak. A case series]. / Drenaje lumbar externo con bomba volumétrica continua en pacientes con fístula cefalorraquídea. Series de casos.

OBJECTIVE: To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. METHODS: Retrospective descriptive case series study. POPULATION: patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP. VARIABLES: age, sex, type of intervention, variables related to the practice of the pump and complications. Average and medians were calculated for quantitative variables, frequencies and percentages for qualitative. RESULTS: Sample: 11 subjects. Incidence in running IP: disconnection, occlusion and acoustic alarm activation. Most frequently complication is headache; a case of pneumocephalus. DISCUSSION: The small number of subjects and the heterogeneity of these do not allow for comparison or establishing associations between variables. The resolution of the cerebrospinal fluid leak with continuous IP is lower in this study than others, and may be influenced by the small number of subjects. It should be noted the frequent activation of the pump alarm for no apparent cause. IMPLICATIONS FOR PRACTICE: Protocol would be developed for preparing the IP team to reduce the acoustic alarm activation, and would make a prospective multicenter study.