Work

Is ventricular lavage a novel treatment of neonatal posthemorrhagic hydrocephalus? a meta analysis

Year: 2023

Type: article

Study designs: Systematic Review, Meta-Analysis

Abstract: Introduction Intraventricular hemorrhage (IVH) may produce obliterative arachnoiditis, which disrupts the flow and absorption of cerebrospinal fluid (CSF), resulting in posthemorrhagic hydrocephalus (PHH). PHH gives a high risk of neurofunctional impairment. Ventricular lavage is the treatment of choice for PHH in neonates with IVH for decades. It’s developing with the combination of fibrinolytic therapy also called drainage, irrigation and fibrinolytic therapy (DRIFT), and with the using of neuroendoscopic apparatus also called neuroendoscopic lavage (NEL). Methods This review is a meta-analysis using the PRISMA method guideline, including the clinical studies comparing ventricular lavage (VL) with standard treatment of PHH between 2000 and 2021. Results VL group reduce the shunt dependency compared to standard treatment (OR = 0.22; 95CI 0.05 to 0.97; p = 0.05). VL group has less infection risk compared to the standard treatment group (RR = 0.20; 95CI 0.07 to 0.59; p < 0.05). The severe neurofunctional outcome is similar between the two groups (OR = 0.99; 95CI 0.13 to 7.23; p = 0.99). The early approach treatment group may give better neurofunctional outcome compared to the late approach (OR = 0.14; 95CI 0.06 to 0.35; p < 0.05). Conclusion VL reduce the shunt dependency on the PHH, decreasing the shunt’s related infection rate. The early ventricular lavage may give benefit for the neurocognitive outcome.

Source: Child s Nervous System

DOI: 10.1007/s00381-022-05790-3

Authors: Muhammad Arifin Parenrengi, IG. M. Aswin R. Ranuh, Wihasto Suryaningtyas

Institution: Universitas Airlangga

Language: English

Topic: Cerebrospinal fluid and hydrocephalus

Subfield: Clinical Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funder: Universitas Airlangga