Gasbag Anaesthesia Forums

Anesthesia Discussion => General Discussion => Topic started by: yogenbhatt1 on September 23, 2011, 11:25:51 AM

Title: CSF Manometry
Post by: yogenbhatt1 on September 23, 2011, 11:25:51 AM
Can any one help me with this?
We get frequent call for CSF Manometry.
We do not have any ready made CSF Manometer. I have seen one set where a needle is attached to a line and a measure tape.
We normally use a 20G BD Spinal needle. Do an LP in lateral position. connect a pressure line( used in ICU for an arterial line) and crudely measure the height of the column.
If needed we remove some CSF afterwards to reduce a raised ICT.

Title: Re: CSF Manometry
Post by: jafo1964 on September 24, 2011, 01:57:06 AM
when you connect it to a column of liquid it measures the pressure in cm of H2O and at best this method of measuring is not very accurate
I have never measured these pressures
but i am sure that we can connect the system to a low pressure transducer and connect it to a monitor used for invasive pressure monitoring and then we can get more accurate results in mmof Hg. the principle is much the same as used to measure the CVP

I am also wondering if a indwelling catheter can be used. Maybe stick in a 22G IV cannula and put the catheter into the subarachnoid space and connect that to a pressure transducer system

I am uncertain whether a slow flush with heparin that we use to prevent from the catheter clotting has any role or is safe in CSF pressure monitoring

Actually even the best centres in India do not routinely monitor CSF pressures, because it is obviosly difficult and the information it yields is at best suspect

Beware the risk of infection spreading via the catheter inwards