Name two infectious complications common after TBI and the general prevention strategies.

• A. Ventilator-associated pneumonia and ventriculitis; prevention includes selective decontamination or prophylaxis
• B. Pneumonia and meningitis; prevention includes vaccines
• C. Ventriculitis only; prevention includes aseptic technique
• D. Ventilator-associated pneumonia and ventriculitis; prevention includes aseptic technique, proper EVD care, head elevation, oral care, and minimized device duration

Answer: (D)

In severe TBI, infections in the ICU are often tied to invasive devices like ventilators and external ventricular drains, so the two most common infectious complications are ventilator-associated pneumonia and ventriculitis. Preventing them hinges on meticulous care of those devices and general infection-control practices. Using strict aseptic technique during insertion and every interaction with the devices reduces introduction of pathogens. For the external ventricular drain, proper care of the drainage system and sterile handling prevent tract infections. Elevating the head of the bed helps reduce aspiration and supports drainage. Maintaining good oral hygiene, including regular oral care, limits colonization that can be aspirated into the lungs. Minimizing the duration of invasive devices—removing the ventilator support and the EVD as soon as they’re no longer needed—significantly lowers infection risk. Vaccines can reduce certain infections in broader populations, but they don’t directly prevent ICU-acquired ventilator-associated pneumonia or ventriculitis, and meningitis is not the usual infectious complication targeted in this setting.