Evidence map›Paper›PMID 40453290›Full record

ArticleCureus2025

External Ventricular Drain Management in Aneurysmal Subarachnoid Hemorrhage: Perspectives and Practices From Low-Income and Middle-Income Countries.

Abhijit V Lele, Hemanshu Prabhakar, Victor Lin, Indu Kapoor, Charu Mahajan, Umeshkumar Athiraman, Nophanan Chaikittisilpa, Ananya Abate Shiferaw, Jorge H Mejia-Mantilla, Peter Tan and 1 more

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Abhijit V LeleNeurocritical Care and Anesthesiology, Harborview Medical Center, Seattle, USA.
Hemanshu PrabhakarNeuroanaesthesiology and Neurocritical Care, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Victor LinNeurology, Harborview Medical Center, Seattle, USA.
Indu KapoorNeuroanaesthesiology and Neurocritical Care, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Charu MahajanNeuroanaesthesiology and Neurocritical Care, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Umeshkumar AthiramanAnesthesiology, Washington University School of Medicine, St. Louis, USA.
Nophanan ChaikittisilpaAnesthesiology, Mahidol University, Bangkok, THA.
Ananya Abate ShiferawAnesthesiology, Addis Ababa University, Addis Ababa, ETH.
Jorge H Mejia-MantillaNeurointensive Care, Fundación Valle del Lili, University Hospital, Cali, COL.
Peter TanAnesthesiology and Intensive Care, Sarawak General Hospital, Kuching, MYS.
Samuel BlackerAnesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to evaluate the current practices, challenges, and quality improvement (QI) opportunities related to external ventricular drain (EVD) care in aneurysmal subarachnoid hemorrhage (aSAH) across low- and middle-income countries (LMICs). The findings were compared to international guidelines, including those by the American Heart Association (AHA), Neurocritical Care Society (NCS), and Society for Neuroscience in Anesthesiology and Critical Care (SNACC).

methodsA cross-sectional survey was conducted between September and December 2024 using a 57-item questionnaire distributed to healthcare providers in LMICs. Data on EVD insertion and management, infection prevention, intracranial pressure (ICP) monitoring, transport practices, and QI metrics were analyzed descriptively, with thematic analysis of free-text responses.

resultsComplete responses were received from 89 participants across 24 countries. Hydrocephalus was the primary indication for EVD insertion (96%), performed mainly in operating rooms (96%) by attending neurosurgeons (73%). Infection-related metrics were reported by 71% of respondents. Key areas for improvement included education, infection prevention, and standardized protocols. The adherence to AHA/NCS/SNACC recommendations was as follows: hydrocephalus as an indication for EVD insertion (96%), sterile technique (91%), EVD clamp trials (81%), indication-based CSF sampling (67%), pre-procedure antibiotics (61%), tunneling catheter (40%), use of anti-microbial-impregnated EVD (17%), and ICP during patient transport (13%).  Conclusions: Significant gaps in EVD care in LMICs highlight the need for tailored QI initiatives. Leveraging campaigns like the SNACC EVD Safety Campaign can drive education, standardization, and improved outcomes. Future efforts should focus on context-specific guidelines and scalable QI practices in resource-limited settings.

Indexed as

aneurysmevdguidelinessubarachnoid hemorrhagetransportventriculostomyxternal ventricular drain

Identifiers

PMID40453290
PMCPMC12124817

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.