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

Hongri Zhang; Chen Fan; Haojie Bi; Xiaowei Hao; Jinghua Peng

doi:10.1055/s-0045-1812327

Asian Journal of Neurosurgery, Table of Contents

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

Authors

Hongri Zhang^*

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

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

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

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

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

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

Full Text

References

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