At what drain output rate is it reasonable to consider a clamp trial?

[Guest]

I'm sure this depends on a lot of other things including the clinical picture, but assuming you have an EVD in and trying to maintain a normal ICP of around 10 cm H2O, how much should the patients be draining per day before you think its reasonable to do a clamp trial?

[Guest]

(05-11-2021, 07:28 PM)Guest Wrote: I'm sure this depends on a lot of other things including the clinical picture, but assuming you have an EVD in and trying to maintain a normal ICP of around 10 cm H2O, how much should the patients be draining per day before you think its reasonable to do a clamp trial?

If drain is set at 20mmHg and less than 15mL has come out over the course of 24 days, most attending at my institute would say pull it. Sometimes though, I think a 24 hour clamp trial isn’t long enough from for some chronic hydrocephalus patients or post-traumatic hydrocephalus patients. Too often I’ve had to throw an emergent redo-EVD because the patient who passed a one day clamp trial and got the EVD pulled then crumped the next day.

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(05-11-2021, 07:39 PM)Guest Wrote:

(05-11-2021, 07:28 PM)Guest Wrote: I'm sure this depends on a lot of other things including the clinical picture, but assuming you have an EVD in and trying to maintain a normal ICP of around 10 cm H2O, how much should the patients be draining per day before you think its reasonable to do a clamp trial?

If drain is set at 20mmHg and less than 15mL has come out over the course of 24 days, most attending at my institute would say pull it. Sometimes though, I think a 24 hour clamp trial isn’t long enough from for some chronic hydrocephalus patients or post-traumatic hydrocephalus patients. Too often I’ve had to throw an emergent redo-EVD because the patient who passed a one day clamp trial and got the EVD pulled then crumped the next day.

Over the course of *24 hours*  (not days)

[Guest]

(05-11-2021, 07:39 PM)Guest Wrote:

(05-11-2021, 07:28 PM)Guest Wrote: I'm sure this depends on a lot of other things including the clinical picture, but assuming you have an EVD in and trying to maintain a normal ICP of around 10 cm H2O, how much should the patients be draining per day before you think its reasonable to do a clamp trial?

If drain is set at 20mmHg and less than 15mL has come out over the course of 24 days, most attending at my institute would say pull it. Sometimes though, I think a 24 hour clamp trial isn’t long enough from for some chronic hydrocephalus patients or post-traumatic hydrocephalus patients. Too often I’ve had to throw an emergent redo-EVD because the patient who passed a one day clamp trial and got the EVD pulled then crumped the next day.

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(05-11-2021, 07:39 PM)Guest Wrote:

(05-11-2021, 07:28 PM)Guest Wrote: I'm sure this depends on a lot of other things including the clinical picture, but assuming you have an EVD in and trying to maintain a normal ICP of around 10 cm H2O, how much should the patients be draining per day before you think its reasonable to do a clamp trial?

If drain is set at 20mmHg and less than 15mL has come out over the course of 24 days, most attending at my institute would say pull it. Sometimes though, I think a 24 hour clamp trial isn’t long enough from for some chronic hydrocephalus patients or post-traumatic hydrocephalus patients. Too often I’ve had to throw an emergent redo-EVD because the patient who passed a one day clamp trial and got the EVD pulled then crumped the next day.

Over the course of *24 hours*  (not days)

That definitely caught my attention, lol