proGAV ® 2.0 Pressure setting

The proGAV 2.0 is available either as a single adjustment unit or in a set with a gravitational unit (six pressure levels are possible).

Standardadjustable unit (cmH2O)gravitational unit (cmH2O)
children up to 5 years of age and adults over 60 years of age0 bis 2020
children over 5 years of age and adults up to 60 years of age0 bis 2025
Recommendation for adjustable unitadjustable unit (cmH2O)
standard (newborns and NPH-patients)5
defensive (e.g. patients with extremely wide ventricles, highly elevated ICP or aqueductal stenosis)10
special (e.g. patients with pseudotumor cerebri)15

Reading the pressure setting on the adjustable unit from an X-ray image

The pressure setting of the proGAV 2.0 should be measured either with the proGAV 2.0 Compass or via X-ray. The position of the rotor determines and indicates the pressure setting in the X-ray. The rotor includes four magnets, arranged in pairs and face to face on top of the rotor, which are recognizable in the X-ray as four white dots. Two additional drill holes on one side of the rotor, arranged on the left respectively right side of the magnets, serve as an additional support for orientation: the two drill holes are recognizable as black dots in the X-ray. The rotor side with the two drill holes can be described as the back side of the rotor. The gap of the two magnets opposite to those on the back side of the rotor is regarded as the trinangle tip. A triangle is formed by visually connecting the magnets and the drill holes. The sharp corner of the triangle indicates the position of the rotor tip. The direction of the rotor tip indicates the pressure setting of the valve.

Reading the pressure setting on the gravitational unit from an X-ray image

The pressure level is denoted by code rings, which are visible in the X-ray image. Gravitational units are available with the following pressure settings:

opening pressure for vertical position (cmH2O)coding of the gravitational unit
0small, no code ring
15large, no code ring
20large, 1 code ring
25large, 2 code rings
30large, 3 code rings
35large, 4 code rings

Customised pressure settings for special cases:

special pressure levelsadjustable unit (cmH2O)gravitational unit (cmH2O)
Special pressure levels should be chosen corresponding to the recommendation of pressure levels as follows:0 - 20without gravitational unit
0 - 2010
0 - 2015
0 - 2030
0 - 2035
characteristicsrecommendation for the gravitational unit
Weight The peritoneal pressure inhibits drainage. Therefore the gravitational unit should be selected according to body-mass-index (BMI), to account for cases involving overweight and adipose patients.
25-29 BMI               - 5 cmH2O below standard recommendation
30-34 BMI               - 10 cmH2O below standard recommendation
35-39 BMI               - 15 cmH2O below standard recommendation
> 40 BMIuse the the adjustable unit only (no gravitational unit necessary)
MobilityStandard levels are suitable for active people. For inactive or bedridden patients, the gravitational unit should be set to the maximum pressure setting (cmH2O).
Height The height of a patient determines the hydrostatic suction effect. In order to compensate for variations in height, we recommend that the gravitational unit is selected accordingly:
< 1,60m               - 5 cmH2O below standard recommendation
> 1,80m               + 5 cmH2O below standard recommendation
InspectionThe adjustable unit is adjusted to 5 cmH2O by the manufacturer. Please check the pressure setting before use.
Body positionIn the horizontal body position, only the adjustable unit determines the opening pressure level. The opening pressure in the vertical body position however is the sum of the opening pressures of both the adjustable and gravitational units.
AdjustmentsChanging the adjustable unit setting also influences the opening pressure of the whole valve in the vertical body position.