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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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The intraperitoneal pressure as a counterforce to CSF diversion in ventriculoperitoneal shunting: Absolute values and correlations with body measurements in mobile subjects.

Meeting Abstract

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  • Brit Böse - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen
  • Katharina Lange - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen
  • Florian Stockhammer - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen
  • Veit Rohde - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen
  • Florian Baptist Freimann - Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 168

doi: 10.3205/15dgnc566, urn:nbn:de:0183-15dgnc5668

Published: June 2, 2015

© 2015 Böse et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: In ventricluoperitoneal shunting, the intraperitoneal pressure (IPP) counteracts the drainage of the cerebrospinal fluid (CSF) into the peritoneal cavity. Animal studies suggest an intrinsic IPP exceeding the intraperitoneal hydrostatic pressure. No data are available on the intrinsic IPP in mobile humans, which has to be corrected for the hydrostatic pressure.

Method: We measured the IPP indirectly (intravesical pressure) in two body positions (supine/upright). Measurements were referenced against the highest point of the peritoneal cavity, which was estimated by ultrasound of the subcutaneous tissue in the supine position, and accepted to match the height of the xiphoid in the upright position. To evaluate the hydrostatic character of the IPP, measurements were repeated with an altered reference height (-10 cm). Pressure data were given in cmH2O, and analyzed using Student's t-test and Pearson's correlation coefficient.

Results: We included 20 subjects (12 male; 8 female) with a mean age of 60 years, a mean body mass index (BMI; kg/m2) of 32.6 (± 7.7) and a mean abdominal girth of 112 (± 17.7) cm. The IPP was measured in the supine position as mean 3.6 (± 2.4) cmH2O, and 3.4 (± 5.5) cmH2O in the upright position (p=0.9). The mean difference to IPP values obtained in a vertical distance of -10cm was 9.1 (± 1.5) cmH2O. A positive correlation was found between the BMI and the IPP (R=0.8; p<0.001).

Conclusions: Our results support the existence of an intrinsic IPP exceeding the intraperitoneal hydrostatic pressure. The IPP increases according to the hydrostatic force. The correlation of the IPP with the BMI might help to select appropriate shunt valve settings in the future.