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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1812327
Original Article

A Method to Guide Pressure Selection for Programmable Pressure Valves after Ventriculoperitoneal Shunt Surgery

Autoren

  • Hongri Zhang   *

    1   Department of Neurosurgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China

  • Chen Fan    *

    1   Department of Neurosurgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China

  • Haojie Bi

    1   Department of Neurosurgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China

  • Xiaowei Hao

    1   Department of Neurosurgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China

  • Jinghua Peng

    2   Department of Rehabilitation Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China

Funding This work was supported by Henan Province Medical Science and Technology Research Plan [grant number: LHGJ20240434].
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Abstract

Introduction

Programmable pressure valves with antisiphon/gravity devices are recommended for ventriculoperitoneal shunts. However, cerebrospinal fluid (CSF) overdrainage and underdrainage still frequently occur because of the lack of effective pressure regulation methods. Therefore, this study aimed to provide a method to guide valve pressure selection after ventriculoperitoneal shunt placement.

Materials and Methods

A total of 31 patients whose valve pressure was lowered for the last time after ventriculoperitoneal shunt placement were enrolled in this study. Glucose solution was injected into the reservoir before and after adjustment, and the residual glucose concentration was measured 20 minutes later. Residual glucose concentrations were then compared between before and after adjustment. In vitro experiments were also conducted to simulate the flow of CSF through the shunt valve and detect the relationship between flow rate and residual glucose concentration.

Results

The glucose concentration in the CSF was significantly decreased after adjusting (mean ± standard deviation, 15 ± 6.6 vs. 5.6 ± 3.1 mmol/L, respectively; p < 0.01).

Conclusion

When the residual glucose concentration is higher than 10 mmol/L, an underdrainage shunt should be considered, and when it is lower than 10 mmol/L, an appropriate pressure should be considered, which provides a reference for lowering the shunt valve pressure.

Keywords

programmable pressure - hydrocephalus - ventriculoperitoneal shunts - cerebrospinal fluid - underdrainage

Authors' Contributions

H.Z. contributed to conceptualization, formal analysis, project administration, writing – original draft, and funding acquisition. C.F. was responsible for writing – original draft, visualization, validation, and methodology. H.B. contributed to software, validation, and data curation. X.H. provided project administration, supervision, and resources. J.P. contributed to writing – review and editing, validation, investigation, and software.


Data Availability Statement

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.


Ethical Approval

All procedures performed in studies involving human participants were approved by and conducted in accordance with the ethical standards of the Ethics Committee of First Affiliated Hospital of Henan University of Science and Technology (Luoyang, Henan, China) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval day: March 2, 2022. Approval number: 2022-03-BOXX.


* Chen Fan and Hongri Zhang are equally to this work and share first authorship.




Publikationsverlauf

Artikel online veröffentlicht:
28. Oktober 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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