ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Bedside external ventricular drainage in the NICU: procedural efficiency and infection trends in a 15-year single-center cohort.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the procedural efficiency of bedside versus operating-room external ventricular drainage (EVD) insertion in a neonatal intensive care unit (NICU) and to describe culture-positive EVD-associated infections.
methodsWe performed a retrospective single-center cohort study of NICU infants who underwent EVD insertion between 2011 and 2025. Operative time and insertion characteristics were analyzed at the insertion level. Culture-positive EVD-associated infections acquired at the study hospital were described, and annual infection incidence was explored in relation to unit methicillin-resistant Staphylococcus aureus (MRSA) acquisition rates.
resultsSixty-six infants underwent 161 EVD insertions (115 bedside, 28 operating room, 18 outside hospital). Among 140 study-hospital insertions with documented operative time, bedside insertion was faster than operating-room insertion (24.5 (11.4) vs 57.4 (35.2) min; adjusted difference, 32.5 min; 95% CI, 16.7-48.4; p < 0.001). Seven study-hospital-acquired culture-positive EVD-associated infections occurred (2.37 per 1000 catheter-days at risk), all during bedside catheter episodes. Median time from catheter insertion to first positive culture was 2 days. In an exploratory annual ecological analysis, infection incidence correlated with NICU MRSA acquisition rates (Pearson r = 0.74; p = 0.009).
conclusionBedside NICU EVD insertion was substantially faster than operating-room insertion after adjustment for case-mix differences. Culture-positive infections occurred only during bedside catheter episodes; therefore, infection findings should be interpreted descriptively rather than as evidence of comparative infection safety.
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