Investigation of Cerebrospinal Fluid Flow Characteristics Through Adult and Pediatric Shunt Tubing

Shunt malfunction in adult and pediatric populations continues to be a perplexing problem. We examined artificial cerebrospinal fluid flow differential between adult and pediatric shunt systems. Flow through adult and pediatric-sized catheters was compared with artificial CSF using shunt systems containing new catheters, explanted catheters, 2-piece catheters, 3-piece catheters and with varying protein levels. The adult and pediatric explanted catheters were: three different lengths (90cm, 52cm, and 25 cm) and were compared to new catheters of the same lengths. New pediatric-sized catheters have a statistically significant increase in resistance to flow when compared to adult catheters of the same lengths (p=0.0001). Explanted pediatric catheters had a slight increase in resistance to flow when compared to adult catheters of similar lengths. For both adult and pediatricsized catheters, as concentration of protein increases, resistance to flow decreases (p<0.05). Resistance to flow in pediatric cerebrospinal fluid shunt systems containing 2-piece catheters, 3-piece catheters is higher than in comparable adult cerebrospinal fluid shunt systems. First study to examine the difference in flow dynamics between adult and pediatric shunts. The results suggest important finding that minimum pieces of shunts should be used to decrease chances of blockage.