Journal of Medical and Surgical Intensive Care Medicine 2018 , Vol 9, Issue 1
Outcomes and Intensive Care Management of Cerebrospinal Fluid Drainage in Patients with Thoracoabdominal Aortic Aneurysm Surgery
İbrahim Mungan 1 , Büşra Tezcan 1 , Derya Ademoğlu 1 , Hayriye Cankar Dal 1 , Sema Turan 1
1Clinic of Intensive Care, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey DOI : 10.5152/dcbybd.2018.1715

Objective: Thoracoabdominal aortic aneurysm (TAAA) surgery is accepted as a life-saving surgical repair, but its postoperative morbidity and mortality rates are high. Postoperative paraplegia and paraparesis, hospital-acquired infections, and renal insufficiency are serious complications that prolong hospital stay. Cerebrospinal fluid drainage (CSFD) has been shown to significantly reduce paraplegia and paraparesis risk, especially when used in combination with other methods. Despite its potential benefits, CSFD is not an innocent process because of possible infectious complications, such as localized infections, meningitis, intracranial hemorrhage, and neurological damage. In the present study, we aimed to appraise the postoperative outcomes and intensive care unit period of patients with TAAA surgery who underwent CSFD.

Material and Methods
: The records of all patients treated at the Türkiye Yüksek İhtisas Training and Research Hospital Cardiovascular Surgery Clinic between January 2014 and January 2018 for TAAA were reviewed retrospectively.

: Although the early mortality rate was reported as 10% in the literature, in non-emergent cases, our mortality rate was higher in the present study. The probable reason for this is that we only assessed CSFD cases and total in-hospital mortality, suggesting that urgent cases constitute half of the patients. Excluding postoperative complications, the morbidity rate was 37.9% when the total number of morbidities following intensive care was included. The rate of CSFD-related complications was 10.33%.

: Previous studies have supported the use of CSFD in TAAA repair, and practical guidelines minimize the connatural risk of CSFD. Therefore, it is crucial to be aware of both the efficacy and the possible risks of CSFD. Although deficiency of the control group and being in retrospective nature prevents precise inferences in the present study, our results are consistent with the literature. We believe that this short-lived study needs to be repeated on a wider basis.

Cite this article as
: Mungan İ, Tezcan B, Ademoğlu D, et al. Outcomes and intensive care management of cerebrospinal fluid drainage in patients with thoracoabdominal aortic aneurysm surgery. Yoğun Bakım Derg 2018; 9 (1): 18-21.

Keywords : Thoracoabdominal aortic aneurysm, cerebrospinal fluid, drainage, surgery