{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:49:38Z","timestamp":1791589778389,"version":"4.3.4"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Accurate control of cerebrospinal fluid (CSF) drainage through external ventricular drains (EVDs) is essential in neurosurgical intensive care. Conventional systems rely on hydrostatic level adjustment, which is operator-dependent and imprecise.<\/jats:p>\n                  <jats:p>This article evaluates the safety, feasibility, and performance of a simple intravenous flow regulator, commonly used in infusion sets, as a cost-effective means of controlling CSF drainage in EVDs across all clinical indications.<\/jats:p>\n                  <jats:p>A prospective observational study was conducted in 300 patients requiring EVD insertion. A standard intravenous flow regulator was attached inline between the EVD outlet tubing and the collection chamber, allowing graded mechanical control of CSF flow. Data regarding patient demographics, indication, drainage volumes, complications, and outcomes were collected. Statistical analysis was performed using SPSS v25 and GraphPad Prism v9.<\/jats:p>\n                  <jats:p>Of 300 patients (mean age 46.3\u2009\u00b1\u200918.2 years; 186 males), indications included intraventricular hemorrhage (28%), subarachnoid hemorrhage (24%), traumatic brain injury (22%), hydrocephalus (14%), posterior fossa surgery (7%), and others (5%). Mean CSF output was 210\u2009\u00b1\u200950\u2009mL\/day. Overdrainage occurred in 3.7%, blockage in 2.3%, and infection in 4.3%. The mortality rate was 10%, unrelated to the device. Nursing satisfaction was high (92%), and cost reduction was approximately 40% compared with conventional adjustable systems.<\/jats:p>\n                  <jats:p>An intravenous flow regulator provides safe, precise, and low-cost mechanical control of CSF outflow in EVDs. This modification offers a viable alternative for resource-limited neurosurgical units.<\/jats:p>","DOI":"10.1055\/s-0046-1823101","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:08:36Z","timestamp":1779836916000},"page":"805-808","source":"Crossref","is-referenced-by-count":0,"title":["Novel Use of an Intravenous Flow Regulator for Controlled Cerebrospinal Fluid Drainage in External Ventricular Drains: A Prospective Single-Center Pilot Study of 300 Patients"],"prefix":"10.1055","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0123-3680","authenticated-orcid":false,"given":"Puneet","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Balaji Cure and Care Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oshin","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3959-3363","authenticated-orcid":false,"given":"Vijay K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagendra S.","family":"Shekhawat","sequence":"additional","affiliation":[{"name":"Department of Radiology, Noor Alhali Medical Center Br 4, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shifali","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","first-page":"467","article-title":"Management of external ventricular drains: review of the literature and authors' experience","volume":"150","author":"R Beer","year":"2008","journal-title":"Acta Neurochir (Wien)"},{"key":"ref2","first-page":"962","article-title":"Early complications of external ventricular drainage: a prospective analysis of 500 cases","volume":"52","author":"W Pfisterer","year":"2003","journal-title":"Neurosurgery"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/00006123-200207000-00024","article-title":"Ventriculostomy-related infections: a critical review of the literature","volume":"51","author":"A P Lozier","year":"2002","journal-title":"Neurosurgery"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"419","DOI":"10.3171\/jns.1996.85.3.0419","article-title":"Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients","volume":"85","author":"K L Holloway","year":"1996","journal-title":"J Neurosurg"},{"key":"ref5","first-page":"143","article-title":"A portable multi-sensor module for monitoring external ventricular drain flow dynamics","volume":"18","author":"T Q Hudson","year":"2021","journal-title":"J Neuroeng Rehabil"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3390\/clinpract13010020","article-title":"External ventricular drainage: a practical guide for neuro-anesthesiologists","volume":"13","author":"A Bertuccio","year":"2023","journal-title":"Clin Pract (Lond)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"116267","DOI":"10.1016\/j.bios.2024.116267","article-title":"Flexible low-profile external ventricular drain catheter for real-time brain monitoring","volume":"255","author":"H Yi","year":"2024","journal-title":"Biosens Bioelectron"},{"key":"ref8","doi-asserted-by":"crossref","DOI":"10.1055\/b-006-161147","volume-title":"Handbook of Neurosurgery. 9th ed","author":"M S Greenberg","year":"2020"},{"key":"ref9","volume-title":"Textbook of Medical Physiology. 14th ed","author":"A C Guyton","year":"2021"},{"key":"ref10","volume-title":"Adams and Victor's Principles of Neurology. 11th ed","author":"A H Ropper","year":"2019"},{"key":"ref11","volume-title":"Review of Medical Physiology. 26th ed","author":"W F Ganong","year":"2020"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.3390\/jpm13091318","article-title":"Implantable intracranial pressure sensor with continuous monitoring: design and feasibility","volume":"13","author":"Y Elsawaf","year":"2023","journal-title":"J Pers Med"},{"issue":"06","key":"ref15","first-page":"886","article-title":"Complications related to external ventricular drainage","volume":"77","author":"D J Kim","year":"2015","journal-title":"Neurosurgery"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s00701-007-1458-9","article-title":"Risk factors for infections related to external ventricular drainage","volume":"150","author":"D Hoefnagel","year":"2008","journal-title":"Acta Neurochir (Wien)"},{"key":"ref17","first-page":"e124","article-title":"Frugal innovations in neurosurgery for low-resource settings: an Indian perspective","volume":"175","author":"V K Gupta","year":"2023","journal-title":"World Neurosurg"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0046-1823101.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:57:02Z","timestamp":1791586622000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0046-1823101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":15,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2026,10,9]]},"published-print":{"date-parts":[[2026,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0046-1823101","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}