DURATION OF INTRACRANIAL-PRESSURE MONITORING DOES NOT PREDICT DAILY RISK OF INFECTIOUS COMPLICATIONS

A GROUP OF 205 patients (115 children and 90 adults) with a total of 2 12 intracranial pressure (ICP) monitors were retrospectively studied w ith attention to daily cerebrospinal fluid cultures, duration of monit oring, associated cranial injuries, and hospital site of the ICP monit or (intensive care unit or operating room). Only closed ICP monitoring systems without irrigation or compliance testing were used, and all p atients received antibiotics as prophylaxis throughout the monitoring period. There were no complications associated with monitor placement. Incidence histograms and regression analysis were used to determine t he daily risk of subsequent infections, in addition to evaluating the cumulative risk of infection, as has been previously described in the literature. No relation between the duration of ICP monitoring and the rate of daily infection through the period of maximal monitoring (1-2 weeks) was found in this series. The overall incidence of infection w as 7.1% with a median duration of monitoring of 7.2 days. The age of t he patient (adult vs. child), site of ICP monitor placement, and natur e of the underlying disease (trauma vs. nontrauma) had no significant effect on the development of monitor-related infections in our study. These data indicate that the decision to continue ICP monitoring can b e based solely on the clinical necessity for further monitoring rather than on concerns for monitor removal to prevent infection.