ArticleCritical care (London, England)2025
Impact of lumbar cerebrospinal fluid drainage to control intracranial hypertension in patients with severe traumatic brain injury: a retrospective monocentric cohort.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Article
- ARDS management in trauma patients.Intensive care medicine · 2026Review
- Efficacy and Predictors of Success of External Ventricular Drainage for the Management of Traumatic Intracranial Hypertension: A Retrospective Multicenter Cohort Study.Neurocritical care · 2026Article
- Four Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study.CNS neuroscience & therapeutics · 2026Article
- Is There a Place for Cerebrospinal Fluid External Lumbar Drainage in Posttraumatic Intracranial Hypertension? Pros, Cons, and Uncertainties.Neurocritical care · 2025Article
- External Lumbar Drainage to Abort Severe Traumatic IntraCranial Hypertension Phase 1 Randomized Clinical Trial: Scientific Rationale and Methodology: An MTBINeurosurgery practice · 2025Article
- Secondary decompressive craniectomy after severe traumatic brain injury: a retrospective cohort study.Frontiers in neurology · 2025Article
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9 authors.
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Abstract
backgroundExternal lumbar drainage (ELD) of cerebrospinal fluid may help control intracranial pressure following a traumatic brain injury. We aimed to assess the efficacy and safety of ELD in post-traumatic intracranial hypertension (IH).
methodsThis retrospective monocentric cohort study was conducted in the trauma critical care unit of the regional Level-I trauma centre between January 2012 and December 2022. All traumatic brain injury patients with IH (≥ 22 mmHg despite optimal sedation) were included. Data collection focused on the duration and management of IH, complications related to ELD, and outcomes (6-month Glasgow Outcome Scale [GOS]). The influence of ELD on the duration of IH was assessed using a multivariable Cox regression analysis, while its impact on the 6-month GOS ("unfavourable outcome" GOS 1-3, "good outcome" GOS 4-5) was evaluated using a multivariable logistic regression analysis.
resultsNinety patients (mean age 37 [SD, 16], injury severity score [ISS] 29 [IQR, 24-34]) were analyzed during the study period. Of these, 50 (56%) benefited from an ELD during their hospitalization (ELD group). The IH duration was significantly reduced in the ELD group (hazard ratio [HR] 1.74 [95% confidence interval (CI) 1.05-2.87; p = 0.03]). One patient (2%) experienced a cerebral herniation following ELD placement, and two others (4%) developed device-associated meningitis. The ELD group was significantly associated with a lower likelihood of an unfavourable outcome (OR 0.32 [95% CI 0.13-0.77]; p = 0.011) compared to the no ELD group.
conclusionELD appears in our cohort to be a safe and effective strategy to control post-traumatic IH, with an acceptable benefit-risk ratio. Our analysis even suggests a potential outcome improvement in patients treated by ELD compared with those having no cerebrospinal fluid drainage.
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