proGAV ® Pressure setting

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

 

 

Standardadjustable unit (cmH2O)

gravitational unit (cmH2O)

children up to 5 years of age and adults over 60 years of age

0 to 2020
children over 5 years of age and adults up to 60 years of age

0 to2025
Recommendation for adjustable unit

adjustable unit (cmH2O)

standard (children 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 should be measured with the proGAV VERIFICATION TOOL. If there is any discrepancy between the desired adjustment setting and the setting on the VERIFICATION TOOL, confirmation can be obtained by way of X-ray imaging. The magnets of the rotor are visible in the image as white dots. The orientation of the rotor tip indicates the pressure setting. The rotor tip can take any position outside the region shown. The opening pressure of the proGAV can be adjusted from 0 to 20 cmH2O, in increments of 1 cmH2O. In order to correctly identify the adjusted opening pressure setting in the X-ray image, the valve has been designed with a distinct flat surface on one side of the housing.

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
10small, 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
characteristics

recommendation for the gravitational unit
WeightThe 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 BMI                 use 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.