E-170 Early experience with patient treatment and drug delivery using irraflow: an automatically irrigating & draining ventricular catheter. (23rd July 2022) - Turner, R
Abstract : Introduction: External ventricular drains are a mainstay of neurosurgical critical care. They are used in the treatment of a large variety of acute neurosurgical illnesses. External ventricular drain technology has not meaningfully changed since their initial introduction. Recently, an automatically irrigating and draining external ventricular catheter Irra flow (Irras, San Diego, CA, USA). Methods: Here we report a series of consecutive cases treated with the IRRA flow device at a large academic medical center. Results: 31 patients were treated with 33 Irra flow devices over a period of 10 months. Diagnoses treated included subdural hematoma (11), intraventricular hemorrhage (16), subarachnoid hemorrhage (2), ventriculitis/abscess (4). Drain days ranged from 1–18 and ICU days ranged from 0–21. Irrigation rates ranged from 0ml/h to 60ml/h. Medications instilled including tPA and vancomycin. 5/31 drains required revision, 4 for suboptimal position and 1 for pre-existing ventriculitis that failed to clear. No drains experienced new infections or clotting that required replacement or revision. Conclusions: Here we present the largest case series using an automatically irrigating and draining ventricular catheter for a variety of diagnoses. Safe and effective protocols for continuously irrigating catheters as well as continuous intrathecal medication administration can be developed. Continuously irrigating ventricular catheters can be safely used in the critical care unit and may avoid some of the most common complications associated with external ventricular drainage. Disclosures: R. Turner: None. B. Khan: None. J. Garavaglia: None. N. Brandmeir: 2; C; IRRAS.