External ventricular drainage (EVD) is widely used in patients with a traumatic brain injury (TBI). However, the EVD weaning trial protocol varies and insufficient studies focus on the intracranial pressure (ICP) during the weaning trial. We aimed to establish the relationship between ICP during an EVD weaning trial and the outcomes of TBI. We enrolled 37 patients with a TBI with an EVD from July 2018 to September 2019. Among them, 26 were allocated to the favorable outcome group and 11 to the unfavorable outcome group (death, post-traumatic hydrocephalus, persistent vegetative state, and severe disability). Groups were well matched for sex, pupil reactivity, admission Glasgow Coma Scale score, Marshall computed tomography score, modified Fisher score, intraventricular hemorrhage, EVD days, cerebrospinal fluid output before the weaning trial, and the complications. Before and during the weaning trial, we recorded the ICP at 1-hour intervals to calculate the mean ICP, delta ICP, and ICP burden, which was defined as the area under the ICP curve. There were significant between-group differences in the age, surgery types, and intensive care unit days (, , and , respectively). During the weaning trial, 28 (75.7%) patients had an increased ICP. Although there was no significant difference in the mean ICP before and during the weaning trial, the delta ICP was higher in the unfavorable outcome group (). Moreover, patients who experienced death and hydrocephalus had a higher ICP burden, which was above 20 mmHg (). Receiver operating characteristic analyses demonstrated the predictive ability of these variables (area under the curve [] for delta ICP and [] for  mmHg). ICP elevation is common during EVD weaning trials in patients with TBI. ICP-related parameters, including delta ICP and ICP burden, are significant outcome predictors. There is a need for larger prospective studies to further explore the relationship between ICP during EVD weaning trials and TBI outcomes.

中文翻译：

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脑室外部引流断奶期间的颅内压是颅脑外伤的预后指标。

外部脑室引流（EVD）广泛用于颅脑外伤（TBI）患者。然而，EVD断奶试验方案各不相同，并且在断奶试验期间，没有足够的研究关注颅内压（ICP）。我们旨在建立EVD断奶试验期间的ICP与TBI结果之间的关系。我们从2018年7月至2019年9月招募了37例EVD的TBI患者。其中，有26例被分配为有利结局组，而11例属于不利结局组（死亡，创伤后脑积水，持续性植物状态和严重残疾） ）。两组在性别，瞳孔反应性，入院格拉斯哥昏迷量表评分，马歇尔计算机断层扫描评分，改良的Fisher评分，脑室内出血，EVD天数，断奶试验前脑脊液输出，和并发症。在断奶试验之前和期间，我们每隔1小时记录一次ICP，以计算平均ICP，增量ICP和ICP负荷（定义为ICP曲线下的面积）。年龄，手术类型和加护病房天数之间存在显着的组间差异（， ，和，分别地）。在断奶试验中，有28名（75.7％）患者的ICP升高。尽管断奶试验之前和期间平均ICP没有显着差异，但不良结局组的ICP较高（）。此外，发生死亡和脑积水的患者的ICP负担更高，超过20 mmHg（）。接收器工作特性分析证明了这些变量的预测能力（曲线下面积） []表示ICP和 []为  毫米汞柱）。在TBI患者的EVD断奶试验中，ICP升高很常见。ICP相关参数（包括增量ICP和ICP负担）是重要的结局指标。需要进行更大的前瞻性研究，以进一步探讨EVD断奶试验期间ICP与TBI结果之间的关系。