Intracranial Pressure Monitoring via External Ventricular Drain: Are We Waiting Long Enough Before Recording the Real Value?
Xiuyun Liu, Margaret Griffith, Hannah J Jang and 7 others
PMID 31899715WHAT IT FOUND
For nurses checking ICP via EVD, most clamping episodes were brief: 65.9% lasted under 1 minute and only 16.3% lasted over 5 minutes, although the protocol required 5 minutes.
Key findings
01Most EVD closure episodes were shorter than one minute: 21,593 of 32,755 episodes (65.9%).
02Only 16.3% of EVD closure episodes lasted longer than 5 minutes.
03Only 7,491 of 32,755 EVD closure episodes (22.9%) met the study's criteria for ICP equilibration before re-opening.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective analysis of monitor data from one hospital, so it describes what happened to EVD closures in that setting. The criteria for deciding when ICP had reached equilibrium were developed by the study team because no commonly accepted criteria existed. The algorithm was not applied to closures under 1 minute, so some very short closures might still have reached equilibrium. The study reported EVD closure times and equilibrium criteria, not patient outcomes.
The easy way to misread this
Do not conclude that every documented ICP value was wrong or that patients were harmed. The study measured how long EVD closures lasted and whether an algorithm-defined equilibrium was reached; it did not compare those values with patient outcomes.