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首页> 外文期刊>Acta neurochirurgica.Supplement >Factors determining mean ICP in hydrocephalic patients with Hakim-programmable valve: implications of the parallel arrangement of the CSF outflow resistance and shunt.
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Factors determining mean ICP in hydrocephalic patients with Hakim-programmable valve: implications of the parallel arrangement of the CSF outflow resistance and shunt.

机译：影响Hakim可编程瓣膜积水脑卒中患者平均ICP的因素：脑脊液流出阻力和分流器平行排列的含义。

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OBJECTIVE: Measurement of CSF pressure is used clinically to test shunt function in vivo in hydrocephalic patients. Criteria for appropriate shunt function have never been validated. METHOD: Hakim-Programmable valve was tested in a model of CSF circulation with variable resistance to CSF outflow (from 12 to 50 mm Hg/ml/min), increased hydrodynamic compliance (> 1.5 ml/mm Hg), and constant perfusion of a rate of 0.4 ml/min, i.e. conditions typical for hydrocephalus. The main question was how the simulated CSF pressure was influenced by the shunt setting and the residual resistance to CSF outflow. RESULTS: Measured baseline CSF pressure correlated well with shunt operating pressure only when high resistance to CSF outflow (50 mm Hg/(ml/min)) was used. For the medium resistance (20 mm Hg/(ml/min)) operating pressure was strongly affected by system's absorption capacity. For low resistance (12 mm Hg/(ml/min)) operating pressure through the valve was independent on valve's settings and no fluid drainage through the valve was recorded. CONCLUSION: Patients with moderately elevated resistance to CSF outflow (12-18 mm Hg/(ml/min)) cannot possibly react to changes of the valve's settings above 100 mm H2O. Mean CSF pressure results both from shunt setting and patient's own re-absorption capacity.
机译：目的：测量脑脊液压力可用于测试脑积水患者的体内分流功能。合适的分流功能的标准尚未得到验证。方法：在CSF循环模型中测试了Hakim可编程瓣膜，该模型具有可变的CSF流出阻力（从12到50 mm Hg / ml / min），增加的流体动力顺应性（> 1.5 ml / mm Hg）和恒定的CSF灌注速度为0.4 ml / min，即脑积水的典型情况。主要问题是分流设置和对CSF流出的残余阻力如何影响模拟的CSF压力。结果：仅当使用对CSF流出的高抵抗力（50 mm Hg /（ml / min））时，测得的基线CSF压力与分流器工作压力相关性良好。对于中等电阻（20毫米汞柱/（毫升/分钟）），操作压力受系统吸收能力的强烈影响。对于低阻力（12 mm Hg /（ml / min）），通过阀门的工作压力与阀门的设置无关，并且未记录通过阀门的流体排泄。结论：对CSF流出的抵抗力适度升高（12-18 mm Hg /（ml / min））的患者可能无法对高于100 mm H2O的阀门设置变化做出反应。 CSF的平均压力来自分流设置和患者自身的重吸收能力。

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