Guidance value of cerebrospinal fluid and serum procalcitonin in the ventricular catheter indwelling time of intracranial pressure monitoring

Abstract

Objective To explore the guidance value of cerebrospinal fluid(CSF) and serum procalcitonin(PCT) in the ventricular catheter indwelling time of intracranial pressure monitoring(ICP). Methods Fifty-eight cases patients with moderate and severe craniocerebral trauma who were given ICP ventricular catheter and external ventricular drainage(EVD) were selected, 5 ml CSF and 2 ml venous blood were collected at operation, 1st, 7th, 14th d after operation.The change of CSF and serum PCT and WBC levels were compared among different time, the correlation among each indicators and diagnosis value for intracranial infection were analyzed. Results The level of CSF and serum PCT and WBC increased with the lengthen of ventricular catheter indwelling time(CSF PCT: (0.09±0.02) μg/L of operation, (1.17±0.25) μg/L of 14 d after the operation; CSF WBC: (24.33±12.75)×106/L of operation, (431.52±140.26)×106/L of 14 d after the operation; serum PCT: (0.16±0.05) μg/L of operation, (4.57±1.41) μg/L of 14 d after the operation; serum WBC: (4.14±0.46)×106/L of operation, (14.24±3.05)×106/L of 14 d after the operation; P<0.05). The CSF PCT was positively correlated with CSF WBC and serum PCT(r=0.614, 0.711, P<0.05). The diagnostic sensitivity of CSF and serum PCT for prognosis of intracranial infection were 95.2%, 81.0%, the specificity were 94.6%, 78.4%, the specificity of CSF PCT was significantly higher than that of serum PCT(P=0.041). Conclusion CSF and serum PCT has high early diagnosis value for intracranial infection in patients with ICP ventricular catheter, which can contribute to guide the reasonable timing of tube drawing, brings out the best of ICP and cerebrospinal fluid drainage, improve the level of treatment in patients with traumatic brain injury. Key words: Cerebrospinal fluid; Serum procalcitonin; Intracranial pressure monitoring; Intracranial infection