• Faraz Behzadi, Miri Kim, Tara Zielke, Carlos F Bechara, Jeffrey Schwartz, and Vikram C Prabhu.
• Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois, USA.
• World Neurosurg. 2021 May 1; 149: e947-e957.

BackgroundAortic disease requiring open or endovascular repair may result in spinal cord injury in approximately 2%-10% of patients. Cerebrospinal fluid diversion using lumbar drains (LDs) has been validated as a protective measure to mitigate this complication.MethodsThis single-institution retrospective study analyzed the implementation of a standardized protocol and subsequent educational intervention for LDs for aortic vascular procedures over a 4-year period.ResultsIn 2016-2019, 45 patients had LDs placed for open or endovascular procedures; group 1 included 19 patients with LDs placed before protocol implementation, and group 2 included 26 patients with LDs placed as per the institutional protocol. Demographics and procedural details in both groups were similar. However, there was a significant difference in the number of patients who had emergent versus planned placement of the LD (group 1, 89.5%; group 2, 50%; P < 0.01), volume of cerebrospinal fluid drained (group 1, 453 mL; group 2, 197 mL; P < 0.01), and compliance with 10 mL/hour drainage recommendation (group 1, 68.4%; group 2, 100%; P < 0.01). In group 1, 5 (31.6%) patients experienced neurological complications compared with only 1 (3.8%) in group 2. LD-related complications occurred 3 patients (15.8%) in group 1, whereas none occurred in group 2. Survey results suggested increased health care worker protocol familiarity with educational interventions.ConclusionsImplementation of an institutional protocol for LDs for open or endovascular procedures is feasible and beneficial. Educational modules improve familiarity among all health care providers, which can improve patient care and complication avoidance.Copyright © 2021 Elsevier Inc. All rights reserved.

35 keywords...

hide…