Q: What is the usual standard for drawing cerebrospinal fluid (CSF) during management of Intra-Cranial Pressure (ICP) management?


Answer: Ventricular CSF drainage is usually done as the first line of invasive management particularly when ICP goes above 20 mmHg. CSF should be drained at a rate of approximately 1-2 cc/minute for 2 minutes. If further removal is required, the interval of at least 2 minutes should be given in between drainages until the desirable ICP is achieved.


Reference: 

Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, et al. Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds. J Neurotrauma 2007; 24 Suppl 1:S55.