Abstract 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. 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. 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. Of 300 patients (mean age 46.3 ± 18.2 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 ± 50 mL/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. 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.
Bansal et al. (Tue,) studied this question.