Where do you zero a lumbar drain?
Figure 1.01: Lumbar ICP/CSF pressure is zeroed to the iliac crest. The panel (left) must be positioned in an upright position, with the “0” reference point (E) at the level of the patient’s catheter.
How do you measure EVD levels?
Levelling the EVD system The laser level device should be in line with the patient’s Foramen of Monro (FOM). If the patient is supine with their head neutral, level the EVD system to the tragus of the ear. If the patient is lateral, level the EVD to the mid sagittal line (between the eyebrows).
What is an ICP waveform?
The ICP waveform consists of three components—(1) respiratory waveforms (0.1–0.3 Hz) associated with the respiratory cycle (W2), (2) pulse pressure waveforms (frequency equal to heart rate), and (3) slow vasogenic waveforms (e.g., ‘Lundberg A and B waves’) [54].
What happens if you drain too much CSF from a lumbar drain?
There is a potential for bleeding around the brain if excess fluid is drained. This procedure has been performed over 1,000 times and only one patient experienced blood inside the skull. This patient had to have surgery to remove the blood.
Where should a lumbar drain be level?
The catheter is placed below the level of the termination of the cord (L2-L3 or below) and within the CSF. The catheter is taped securely to the skin to prevent dislodgement, and connected to a manometer, which should be set at 10cm/H20, measured from the lumbar drain insertion site.
What’s the most serious complication of lumbar puncture?
Cerebral herniation — The most serious complication of LP is cerebral herniation.
What is a Dicrotic wave?
dicrotic wave the second portion of the tracing of a sphygmograph of the arterial pulse or arterial pressure after the dicrotic notch, attributed to the reflected impulse of closure of the aortic valves. Called also recoil wave.
What is a lumbar drain used for in neurosurgery?
Lumbar Drain. Lumbar drainage of cerebrospinal fluid (CSF) has many applications in neurosurgery. It can be used for decompression of CSF spaces, management of intracranial hypertension, and repair of a CSF leak or fistula. Clinical indications, successful insertion, and postoperative management are important skills that will be reviewed here.
What is lumbar drainage of cerebrospinal fluid?
Lumbar drainage of cerebrospinal fluid (CSF) has many applications in neurosurgery. It can be used for decompression of CSF spaces, management of intracranial hypertension, and repair of a CSF leak or fistula. Clinical indications, successful insertion, and postoperative management are important skills that will be reviewed here.
What is the role of lumbar CSF drainage in the treatment of tumors?
Tumors that cause a significant edema often lead to brain herniation through the craniotomy defect during and after dural opening, and lumbar CSF drainage can prevent cortical contusions caused by this herniation.
What is the purpose of the lumbar drain in TAAA surgery?
The purpose of the lumbar drain in the TAAA surgery: to reduce pressure in the spinal cord or brain by draining cerebrospinal fluid(CSF) Increased Pressure =Reduce blood flow