Supplementary material
Search Strategy
We used the following search strategy to search MEDLINE. We adapted the search
strategy to search EMBASE, CINAHL, and COCHRANE. The search excluded articles
in languages other than English, case series of five or less, primarily pediatric studies,
non-human studies, editorials, comments, letters or news or unpublished presentations
MEDLINE (Ovid)
Base Search
Ventriculostom*[tiab] or external ventricular drain*[tiab] or extraventricular drain*[tiab]
or extra ventricular drain*[tiab] or ventricular access device* [tw] or cerebrospinal fluid
shunts [MESH] or cerebrospinal fluid diversion*[tiab] or drainage/adverse effects[majr]
or cerebral ventricles/surgery[MESH] or neurosurgical procedures [mh:noexp] or
cerebrospinal fluid/surgery[MESH] or intracranial hypertension/surgery[MESH] or
lateral ventricles/surgery[MESH] or hydrocephalus/surgery[MESH] or
neurosurgery[MESH])
Base search was combined (AND) with one of the following 3 searches:
1)
Infection
Antibiotic prophylaxis [MESH] or prosthesis-related infections [MESH] or infection
control[MESH]) or surgical wound infection[MESH] or infection*[tw] or infectious*[tw]
or infection[mh:noexp] or catheter-related infections[MESH] or cerebral
ventriculitis[MESH] or ventriculitis*[tw] or cross infection*[MESH] or encephalitis*[tw]
or meningitis[tw] or central nervous system infection*[MESH] or antibiotic*[tw] or
antimicrobial*[tw] or anti-bacterial agents[tw] or anti-bacterial agents[pa])
2)
Management
Sample*[tw] or sampling*[tw] or catheter obstruction [MESH] or catheter
obstruction*[tw] or saline [tw] or tissue plasminogen activator[MESH] or t-pa[tiab] or
tisokinase [tw] or t-plasminogen activator*[tw] or t plasminogen activator*[tw] or
alteplase*[tw] or rt-pa[tw] or rtpa[tw] or bandages[MESH] or bandage*[tw] or
dressing*[tw] or hydrocephalus [MESH] or hydrocephal*[tw] or cerebral
ventriculomegal*[tw] or aqueductal stenos*[tw]
3)
Insertion Complications
A) hemorrhage*[tiab] or haemorrhage*[tiab] or bleeding*[tiab] or blood loss[tiab])
or hemorrhage[MESH:noexp]) or blood loss, surgical[MESH]) or hematoma[MESH])
or intracranial hemorrhages[MESH] or postoperative hemorrhage[MESH])
Or
B) (operating rooms [MESH] or operating room*[tiab]) or procedure room*[tiab] or
ambulatory surgical procedures [MESH] or ambulatory surger*[tw] or emergency
service, hospital [MESH:noexp] or emergency room*[tiab] or emergency
department*[tiab] or (hospital units[MESH:noexp]) and (neurosurg*[tw] or
neurolog*[tw] or neuroscience*[tw]) or intensive care units [MESH:noexp] or nonsurgical setting*[tiab] or nonsurgical setting*[tiab] or non-surgical center*[tiab] or
nonsurgical center*[tiab] or nonsurgical centre*[tiab] or outside the operating
room*[tiab])
Or
C) experienced surgeon*[tiab] and (neurosurgery[tw] or neurological[tw] or
neurology[tw] or neurosurgical[tw])
hospitalists[MESH] or hospitalist*[tiab] or house staff physician*[tiab] or house-staff
physician*[tiab]) or attending physician*[tiab] or technical skill*[tiab] or surgical
expertise[tiab] or case volume*[tiab] or hospitals, low-volume [MESH] or lowvolume[tiab] or low volume[tiab] or hospitals, high-volume [MESH] or highvolume[tw] or high volume[tw] or volume-outcome[tiab] or procedural volume[tiab]
or subspecialty[tiab] or sub-specialty[tiab] or neurosurgery/education [MESH] or
neurosurgical procedures/education[MESH] or learning curve*[tiab] or education,
medical [MESH] or specialty[tiab] or sub-specialist*[tiab] or subspecialist*[tiab] or
credentialing [MESH] or internship and residency [MESH] or procedural
experience[tiab] or clinical competence [MESH]
Or
D) anticoagulants [pharmacological action] or anticoagulants [MESH] or
anticoagula*[tw] or heparin [MESH] or heparin*[tiab] or warfarin [MESH] or
warfarin[tw] or coumadin*[tw] or coumarins[tw] or (deep vein thrombos*[tw] and
(prophyla*[tw] or preven*[tw]) or venous thrombosis/prevention and control [MESH]
or dvt prophyla*[tiab] or deep vein thrombosis prophyla*[tiab]
Or
E) (intraoperative neurophysiological monitoring [MESH]) or monitoring,
intraoperative[MESH]or neuronavigation[MESH])
Or
F) ( intraoperative period[MESH] or intraoperativ*[tiab]) and (ultrasound*[tiab] or
ultrasonography, doppler, pulsed[MESH] or ultrasonography, doppler, transcranial
[MESH] or ultrasonography, interventional[MESH]) or
ultrasonography[MESH:noexp]or echoencephalography[MESH]) or elasticity
imaging techniques [MESH] or endosonography[MESH]) or ultrasonography,
doppler[MESH:noexp]or ultrasonography, doppler, duplex[MESH]or stereotaxic
techniques[MESH] or stereotaxic techni*[tiab] or stereotactic techni*[tiab]) or
ghajar*[tiab] or image guided stereota*[tiab] or image-guided stereota*[tiab] or
(surgery, computer-assisted[MESH])
Or
G) (ventricular*[tiab] or ventricl*[tiab]) and (cerebral*[tw] or brain*[tw]) and
(side[tiab] or sides[tiab] or site*[tiab]) or (cerebral ventricles[MESH] and (side[tiab]
or sides[tiab] or site*[tiab])
Searching other resources
Besides the electronic search we identified relevant trials by searching references listed in
published studies and personal reference collections.
Results of the Search
The initial search returned the following results:
Returned 2520 unique references in the Infection search
Returned 2392 unique references in the Insertion Complications search
Returned 1607 unique references in the Management search
Duplicates between the three search strategies were eliminated for a total of 3578 unique
references
All references were reviewed by at least one committee member. Initial review produced
a list of pertinent papers (about 10% of total)
Found 529 pertinent references in the Infection search
Found 302 pertinent references in the Insertion Complications search
Found 68 pertinent references in the Management search
Subsequent review of each of these papers by a minimum of 2 committee members,
reduced the number of references by another 90%.