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.
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.