Ventricular Lavage for Shunt-Associated Ventriculitis in Children: An Integrative Review
DOI:
https://doi.org/10.46900/apn.v8i2.390Keywords:
Hydrocephalus, Ventriculoperitoneal Shunt, Ventriculitis, Neuroendoscopy, Ventricular lavage, Central nervous system infectionAbstract
Introduction/Background: Hydrocephalus is one of the most common neurosurgical conditions in the pediatric population, with ventriculoperitoneal shunt (VPS) as standard treatment. Infectious complications, especially ventriculitis, represent a major therapeutic challenge due to bacterial biofilm formation and limited antibiotic penetration into the CNS. Ventricular lavage (VL) has emerged as a possible adjuvant strategy.
Methods: Integrative literature review following PRISMA guidelines. Search conducted in PubMed, Scopus, Embase, Web of Science, Cochrane, BVS and SciELO using descriptors related to pediatric population, ventricular lavage and CNS infections. Studies published in the last 10 years in English, Portuguese and Spanish were included. After identification of 320 studies, duplicates were removed and screening by title, abstract and full-text reading was performed, resulting in the final inclusion of 9 articles.
Results: The 9 included studies consistently reported favorable outcomes with neuroendoscopic ventricular lavage, including rapid CSF sterilization, reduction of inflammatory parameters, shorter hospitalization, and lower rates of shunt dysfunction and reinfection compared to conventional treatment.
Conclusions: Ventricular lavage represents a promising adjuvant therapeutic strategy in the treatment of ventriculitis associated with VPS in pediatric patients, potentially contributing to better clinical outcomes. However, its incorporation into clinical practice still depends on more robust prospective studies confirming its efficacy and safety.
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