The following is a summary of “Intraventricular Lavage vs External Ventricular Drainage for Intraventricular Hemorrhage: A Randomized Clinical Trial,” published in the October 2023 issue of Neurology by Haldrup et al. 

For a study, researchers examined intraventricular lavage’s safety and effectiveness in treating intraventricular hemorrhage. A single-blinded, controlled clinical trial in Denmark enrolled 58 patients—initial analysis for the first 20 participants assessed catheter-related risks, infections, and other safety measures. The main outcomes included catheter occlusions and hematoma clearance, assessing treatment efficacy. The trial spanned from January to November 2022, with follow-up lasting 90 days, and data analysis occurred between February and April 2023.

The study involved 21 participants (median age, 67 years), most experiencing secondary intraventricular hemorrhage; 11 received intraventricular lavage, while 10 underwent standard drainage. The trial ended early due to elevated severe adverse events associated with intraventricular lavage, revealing a notably higher risk compared to drainage (risk difference 0.43, P = .04). Catheter occlusion rates were notably greater with intraventricular lavage than drainage, though the difference was not statistically significant (38% vs 7%, hazard ratio 4.4, P = .14). Intraventricular lavage procedures took significantly longer than the control (median time 53.5 vs 12 minutes, P < .001).

The comparison between intraventricular lavage and standard drainage revealed a notably higher occurrence of severe adverse events with intraventricular lavage. Prudent usage of this device is advised to prioritize patient safety.

Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2810442