Repeatability of cerebrospinal fluid constant rate infusion study

D. M. A. Swallow, N. Fellner, G. V. Varsos, M. Czosnyka*, P. Smielewski, J. D. Pickard, Z. Czosnyka

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: Infusion tests are important tools to assess cerebrospinal fluid (CSF)dynamics used in the preoperative selection of patients for shunt surgery, or to predict the scope of improvement from shunt revision. The aim of this study was to assess the repeatability of the key quantitative parameters describing CSF dynamics that are determined with infusion testing. 


Materials and Methods: Eighteen patients in whom a constant infusion test was repeated within 102 days, without any intermediate surgical intervention, were studied. From each test baseline ICP, baseline pulse amplitude, outflow resistance, elastance coefficient and slope of the amplitude-pressure line were calculated and investigated with a regression and Bland-Altman analysis. 


Results: Significant correlations (P < 0.01) were found for the outflow resistance (R = 0.96), the elastance coefficient (R = 0.778) and the slope of the amplitude-pressure line (R = 0.876). The estimated 95% confidence level for outflow resistance was 3 mmHg/ml min. Likewise, the elastance coefficient lay within a range of 0.16/ml and the slope of the amplitude-pressure line within 0.25. The most inconsistent parameter found were baseline ICP (R = 0.272) and baseline pulse amplitude (R = 0.171). 


Conclusion: The results of this study imply that the parameters resulting from an infusion study have to be considered within a range rather than as an absolute value.

Original languageEnglish
Pages (from-to)131-138
Number of pages8
JournalActa Neurologica Scandinavica
Volume130
Issue number2
Early online date24 Mar 2014
DOIs
Publication statusPublished - Aug 2014

Fingerprint

Cerebrospinal Fluid
Pressure
Hydrodynamics
Patient Selection

Keywords

  • Cerebrospinal fluid
  • Hydrocephalus
  • Infusion test
  • Intracranial pressure

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Swallow, D. M. A., Fellner, N., Varsos, G. V., Czosnyka, M., Smielewski, P., Pickard, J. D., & Czosnyka, Z. (2014). Repeatability of cerebrospinal fluid constant rate infusion study. Acta Neurologica Scandinavica, 130(2), 131-138. https://doi.org/10.1111/ane.12246

Repeatability of cerebrospinal fluid constant rate infusion study. / Swallow, D. M. A.; Fellner, N.; Varsos, G. V.; Czosnyka, M.; Smielewski, P.; Pickard, J. D.; Czosnyka, Z.

In: Acta Neurologica Scandinavica, Vol. 130, No. 2, 08.2014, p. 131-138.

Research output: Contribution to journalArticle

Swallow, DMA, Fellner, N, Varsos, GV, Czosnyka, M, Smielewski, P, Pickard, JD & Czosnyka, Z 2014, 'Repeatability of cerebrospinal fluid constant rate infusion study', Acta Neurologica Scandinavica, vol. 130, no. 2, pp. 131-138. https://doi.org/10.1111/ane.12246
Swallow DMA, Fellner N, Varsos GV, Czosnyka M, Smielewski P, Pickard JD et al. Repeatability of cerebrospinal fluid constant rate infusion study. Acta Neurologica Scandinavica. 2014 Aug;130(2):131-138. https://doi.org/10.1111/ane.12246
Swallow, D. M. A. ; Fellner, N. ; Varsos, G. V. ; Czosnyka, M. ; Smielewski, P. ; Pickard, J. D. ; Czosnyka, Z. / Repeatability of cerebrospinal fluid constant rate infusion study. In: Acta Neurologica Scandinavica. 2014 ; Vol. 130, No. 2. pp. 131-138.
@article{4ee446bdb8e24d158ad77b43114b5556,
title = "Repeatability of cerebrospinal fluid constant rate infusion study",
abstract = "Objective: Infusion tests are important tools to assess cerebrospinal fluid (CSF)dynamics used in the preoperative selection of patients for shunt surgery, or to predict the scope of improvement from shunt revision. The aim of this study was to assess the repeatability of the key quantitative parameters describing CSF dynamics that are determined with infusion testing. Materials and Methods: Eighteen patients in whom a constant infusion test was repeated within 102 days, without any intermediate surgical intervention, were studied. From each test baseline ICP, baseline pulse amplitude, outflow resistance, elastance coefficient and slope of the amplitude-pressure line were calculated and investigated with a regression and Bland-Altman analysis. Results: Significant correlations (P < 0.01) were found for the outflow resistance (R = 0.96), the elastance coefficient (R = 0.778) and the slope of the amplitude-pressure line (R = 0.876). The estimated 95{\%} confidence level for outflow resistance was 3 mmHg/ml min. Likewise, the elastance coefficient lay within a range of 0.16/ml and the slope of the amplitude-pressure line within 0.25. The most inconsistent parameter found were baseline ICP (R = 0.272) and baseline pulse amplitude (R = 0.171). Conclusion: The results of this study imply that the parameters resulting from an infusion study have to be considered within a range rather than as an absolute value.",
keywords = "Cerebrospinal fluid, Hydrocephalus, Infusion test, Intracranial pressure",
author = "Swallow, {D. M. A.} and N. Fellner and Varsos, {G. V.} and M. Czosnyka and P. Smielewski and Pickard, {J. D.} and Z. Czosnyka",
note = "Acknowledgements This study was supported by the National Institute of Health Research, Biomedical Research Centre (Neuroscience Theme) and NIHR Senior Investigator Awards (JDP). We thank Dr. Hugh K.Richards for checking our statistical methodology and results. GVV is supported by an A. G. Leventis Foundation Scholarship.",
year = "2014",
month = "8",
doi = "10.1111/ane.12246",
language = "English",
volume = "130",
pages = "131--138",
journal = "Acta Neurologica Scandinavica",
issn = "0001-6314",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Repeatability of cerebrospinal fluid constant rate infusion study

AU - Swallow, D. M. A.

AU - Fellner, N.

AU - Varsos, G. V.

AU - Czosnyka, M.

AU - Smielewski, P.

AU - Pickard, J. D.

AU - Czosnyka, Z.

N1 - Acknowledgements This study was supported by the National Institute of Health Research, Biomedical Research Centre (Neuroscience Theme) and NIHR Senior Investigator Awards (JDP). We thank Dr. Hugh K.Richards for checking our statistical methodology and results. GVV is supported by an A. G. Leventis Foundation Scholarship.

PY - 2014/8

Y1 - 2014/8

N2 - Objective: Infusion tests are important tools to assess cerebrospinal fluid (CSF)dynamics used in the preoperative selection of patients for shunt surgery, or to predict the scope of improvement from shunt revision. The aim of this study was to assess the repeatability of the key quantitative parameters describing CSF dynamics that are determined with infusion testing. Materials and Methods: Eighteen patients in whom a constant infusion test was repeated within 102 days, without any intermediate surgical intervention, were studied. From each test baseline ICP, baseline pulse amplitude, outflow resistance, elastance coefficient and slope of the amplitude-pressure line were calculated and investigated with a regression and Bland-Altman analysis. Results: Significant correlations (P < 0.01) were found for the outflow resistance (R = 0.96), the elastance coefficient (R = 0.778) and the slope of the amplitude-pressure line (R = 0.876). The estimated 95% confidence level for outflow resistance was 3 mmHg/ml min. Likewise, the elastance coefficient lay within a range of 0.16/ml and the slope of the amplitude-pressure line within 0.25. The most inconsistent parameter found were baseline ICP (R = 0.272) and baseline pulse amplitude (R = 0.171). Conclusion: The results of this study imply that the parameters resulting from an infusion study have to be considered within a range rather than as an absolute value.

AB - Objective: Infusion tests are important tools to assess cerebrospinal fluid (CSF)dynamics used in the preoperative selection of patients for shunt surgery, or to predict the scope of improvement from shunt revision. The aim of this study was to assess the repeatability of the key quantitative parameters describing CSF dynamics that are determined with infusion testing. Materials and Methods: Eighteen patients in whom a constant infusion test was repeated within 102 days, without any intermediate surgical intervention, were studied. From each test baseline ICP, baseline pulse amplitude, outflow resistance, elastance coefficient and slope of the amplitude-pressure line were calculated and investigated with a regression and Bland-Altman analysis. Results: Significant correlations (P < 0.01) were found for the outflow resistance (R = 0.96), the elastance coefficient (R = 0.778) and the slope of the amplitude-pressure line (R = 0.876). The estimated 95% confidence level for outflow resistance was 3 mmHg/ml min. Likewise, the elastance coefficient lay within a range of 0.16/ml and the slope of the amplitude-pressure line within 0.25. The most inconsistent parameter found were baseline ICP (R = 0.272) and baseline pulse amplitude (R = 0.171). Conclusion: The results of this study imply that the parameters resulting from an infusion study have to be considered within a range rather than as an absolute value.

KW - Cerebrospinal fluid

KW - Hydrocephalus

KW - Infusion test

KW - Intracranial pressure

UR - http://www.scopus.com/inward/record.url?scp=84904767156&partnerID=8YFLogxK

U2 - 10.1111/ane.12246

DO - 10.1111/ane.12246

M3 - Article

VL - 130

SP - 131

EP - 138

JO - Acta Neurologica Scandinavica

JF - Acta Neurologica Scandinavica

SN - 0001-6314

IS - 2

ER -