Cost and Outcome in a Series of Shunted Premature Infants with Intraventricular Hemorrhage

McCallum, Jack E.; Turbeville, David F.

doi:10.1159/000120766

Cited by 34 publications

(12 citation statements)

References 12 publications

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“…At a distance from the initial period, children shunted for PHH present a tendency toward septation [23]. Septation was a cause of shunt obstruction in 17% of cases reported by McCallum and Tuberville [24], a figure similar to ours (17.9%). Overdrainage can also be a major problem after shunting with low-pressure valves.…”

Section: Discussionsupporting

confidence: 73%

Early Treatment of Posthemorrhagic Hydrocephalus in Low-Birth-Weight Infants with Valveless Ventriculoperitoneal Shunts

Vinchon¹,

Fabrice

Duquennoy

et al. 2001

Pediatr Neurosurg

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The surgical treatment of posthemorrhagic hydrocephalus (PHH) in low-birth-weight infants (LBWI) is debated. In a few cases, hydrocephalus progresses rapidly and requires early drainage, but valves and ventriculostomy have a high rate of complications in the early phase. Temporary valveless shunt (VLS) is proposed as an alternative treatment of acute PHH in LBWI. Thirteen infants with PHH, weighing less than 2,000 g at birth, were treated with VLS, which was systematically converted into a valve-regulated shunt (VRS) after a few weeks; during the same period, 27 others were treated with VRS initially. The use of VLS presented significantly more shunt obstructions, but not more shunt infections, than VRS. Although placement of VLS was performed earlier, and in smaller babies than VRS, the outcome after a mean 9.1-year follow-up period was comparable in both groups, and only shunt infection was correlated with a poor outcome. We conclude that VLS is a valuable treatment of rapidly evolving PHH in LBWI.

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Section: Discussionsupporting

confidence: 73%

Early Treatment of Posthemorrhagic Hydrocephalus in Low-Birth-Weight Infants with Valveless Ventriculoperitoneal Shunts

Vinchon¹,

Fabrice

Duquennoy

et al. 2001

Pediatr Neurosurg

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“…However, the cost of valve regulated cerebrospinal fluid shunt systems used in the treatment of hydrocephalus, intracranial cysts and pseudotumour cerebri, are relatively inexpensive when compared with the total cost of treatment and care for some of these disorders. [12][13][14][15] Moreover, by adjusting the valves opening pressure, money can be saved by avoiding the cost of valve exchanges and avoiding surgical treatment of subdural haematomas and hygromas. 11,16 The aim of the present study was to make a theoretical cost analysis of the Codman Hakim Programmable Valve (CHPV), also known as the programmable Medos valve (Johnson and Johnson, Raynham, MA) when it is implanted in all patients in need of a CSF shunt valve, whatever the diagnosis or previous shunt history.…”

Section: Introductionmentioning

confidence: 99%

Do adjustable shunt valves pressure our budget? A retrospective analysis of 541 implanted Codman Hakim programmable valves

Zemack

Romner

2001

British Journal of Neurosurgery

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Based on a retrospective study in which a total of 541 Codman Hakim Programmable Valves (CHPV) were implanted in 477 patients over a 6-year period, this cost analysis was performed. By using a valve with an adjustable opening pressure, valve exchange to alter the opening pressure and surgical evacuation of subdural haematomas and hygromas can be avoided. Dividing the added cost for using the CHPV by the cost of implanting a non-programmable Hakim valve results in 105.8 valve exchanges, which would have had to be avoided to break even financially. On 107 occasions a valve was adjusted by a magnitude of 50 mmH2O or more. This, if an adjustment of that magnitude is said to correspond to a valve exchange, is sufficient to break even. The analysis suggests that the extra cost of the valve is outweighed by the ability to adjust the opening pressure setting non-invasively.

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“…Levi and colleagues had 83% obstruction of shunt in preterm infants with PHH(in 83% of cases). Lin had in 89% of cases, 94%(of cases) of the McCallum and Scarff in 50% shunt obstruction (and Scarf had shunt obstruction in 50% of cases) (22,23,25,38,41).…”

Section: Resultsmentioning

confidence: 97%

Surgical treatment problems of hydrocephalus caused by spontaneus intraventricular hemorrhage in prematurely born children

Mihajlovic

Bogosavljevic²,

Nikolić³

et al. 2013

Turkish Neurosurgery

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AIm:The aim of this study was to identify the most appropriate method of surgical treatment of hydrocephalus in preterm infants that is caused by spontaneous intraventricular hemorrhage (IVH) and to identify predictive factors of poor perioperative outcomes. mAteRIAl and methods:We present a series of 60 patients with IVH and hydrocephalus, to whom a VP shunt or subcutaneous (Omaya) reservoir was placed, during the period from March 2006 to March 2011. Results ConClusIon:The outcome of hydrocephalus caused by IVH in premature born children is the worst in perinatology. Our results suggest that the main predictive factor is preoperative condition of the child and that the VP shunt and Omaya reservoir are complementary methods of surgical treatment. sonuÇ: Prematüre çocuklarda intraventriküler kanama nedeniyle oluşan hidrosefalinin sonuçları perinatoloji hastalıkları arasında en kötülerinden biridir. Sonuçlarımız ana prediktif faktörün çocuğun preoperatif durumu olduğunu ve VP şant ve Omaya rezervuarının tamamlayıcı cerrahi tedavi yöntemleri olduğunu göstermektedir.

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Cost and Outcome in a Series of Shunted Premature Infants with Intraventricular Hemorrhage

Cited by 34 publications

References 12 publications

Early Treatment of Posthemorrhagic Hydrocephalus in Low-Birth-Weight Infants with Valveless Ventriculoperitoneal Shunts

Early Treatment of Posthemorrhagic Hydrocephalus in Low-Birth-Weight Infants with Valveless Ventriculoperitoneal Shunts

Do adjustable shunt valves pressure our budget? A retrospective analysis of 541 implanted Codman Hakim programmable valves

Surgical treatment problems of hydrocephalus caused by spontaneus intraventricular hemorrhage in prematurely born children

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