Selection Of The Appropriate Pressure Level; Reading The Pressure Setting From An X-Ray Image - MIETHKE proGAV 2.0 Instrucciones De Manejo

GB | INSTRUCTIONS FOR USE
SELECTION OF THE APPROPRIATE
PRESSURE LEVEL
Horizontal position
The opening pressure for the horizontal body
position is achieved using the adjustable dif-
ferential pressure unit. Here, the pressure
stage should be set in accordance with
the clinical picture and indications. Depend-
ing on the clinical picture and age of the
patient, the opening pressure for this posi-
tion can be selected between pressure levels
0 and 20 cmH O.
2
Vertical position
The proGAV 2.0 opening pressure for the ver-
tical body position is calculated from the sum
of the opening pressure of the adjustable dif-
ferential pressure unit and the gravitational
unit. Patient size, activity level and poten-
tially increased abdominal pressure (obesity)
should be taken into account in selecting
the opening pressure for this position (see
pressure level recommendations at https://
www.miethke.com/en/products/downloads/).
READING THE PRESSURE SETTING
FROM AN X-RAY IMAGE
The set pressure level of the proGAV 2.0
should always be checked using the proGAV
2.0 Compass, but it can also be checked using
an x-ray image. The rotor setting is decisive
in this case. The four magnets in the rotor
can be seen on the x-ray image as white
points and are located opposite each other in
pairs. Two additional burrholes (right and left
next to the magnet pairs) on one side of the
rotor can be used as orientation. They can
be seen as black points on the x-ray image.
This side can be designated as the rotor rear
side. The two front magnets are opposite. The
space between these two magnets can be
considered as the triangle apex. The pressure
level can be read off using the orientation of
this intermediate space. The triangle apex can
take up any position except the space labelled
as a non-adjustable area in Fig. 5. This means
that the opening pressure of the proGAV 2.0
can be infinitely variably adjusted from 0 up to
20 cmH O.
2
16
To ensure that the pressure stage is not read
off as a mirror image, the valve is provided
with a valve marking on one side which is visi-
ble as black in the x-ray image - on a plan view
of the implanted valve as in Fig. 6 the recess
on the right-hand side is visible.
Fig. 5: Schematic representation of rotor in x-ray
image 1. Admittance markings 2. Valve marking 3.
Non-adjustable range 4. Triangle apex
Fig. 6: x-ray image of an adjustable differential pres-
sure unit, setting 14 cmH 2 O
The pressure levels can be identified by cod-
ing in the x-ray image. The following pressure
levels are possible for the gravitational unit:
Opening Gravitationalt unit
pressure for coding
the vertical
position
10 cmH O no ring, small (Fig. 7b)
2
15 cmH O no ring, large
2
20 cmH O 1 ring, large (Fig. 7a)
2
25 cmH O 2 rings, large
2
30 cmH O 3 rings, large
2
35 cmH O 4 rings, large
2
proGAV 2.0