Alteration of the Pressure Setting of a Codman-Hakim Programmable Valve by a Television-Case Report-

Utsuki, Satoshi; Shimizu, Satoru; Oka, Hiroyuki; Suzuki, Sachio; Fujii, Kiyotaka

doi:10.2176/nmc.46.405

Cited by 19 publications

(8 citation statements)

References 11 publications

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“…This re-configuration mechanism allows for unrelated electronic devices with magnetic fields to change valve settings [ Table 1 ]. [ 2 3 4 11 14 ] Even amusement park rides can cause maladjustment of valves. [ 10 ] Despite these risks, programmable valves, when compared to nonprogrammable shunts, are found to be associated with a significant decrease in complications regarding over or underdrainage, as well as a reduction in overall complications.…”

Section: Introductionmentioning

confidence: 99%

Maladjustment of programmable ventricular shunt valves by inadvertent exposure to a common hospital device

Fujimura¹,

Lober²,

Kamian³

et al. 2018

Surg Neurol Int

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Background:Programmable ventricular shunt valves are commonly used to treat hydrocephalus. They can be adjusted to allow for varying amounts of cerebrospinal fluid (CSF) flow using an external magnetic programming device, and are susceptible to maladjustment from inadvertent exposure to magnetic fields.Case Description:We describe the case of a 3-month-old girl treated for hydrocephalus with a programmable StrataTM II valve found at the incorrect setting on multiple occasions during her hospitalization despite frequent reprogramming and surveillance. We found that the Vocera badge, a common hands-free wireless communication system worn by our nursing staff, had a strong enough magnetic field to unintentionally change the shunt setting. The device is worn on the chest bringing it into close proximity to the shunt valve when care providers hold the baby, resulting in the maladjustment.Conclusion:Some commonly used medical devices have a magnetic field strong enough to alter programmable shunt valve settings. Here, we report that the magnetic field from the Vocera hands-free wireless communication system, combined with the worn position, results in shunt maladjustment for the StrataTM II valve. Healthcare facilities using the Vocera badges need to put protocols in place and properly educate staff members to ensure the safety of patients with StrataTM II valves.

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Section: Introductionmentioning

confidence: 99%

Maladjustment of programmable ventricular shunt valves by inadvertent exposure to a common hospital device

Fujimura¹,

Lober²,

Kamian³

et al. 2018

Surg Neurol Int

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“…Previous studies have revealed that even low-intensity magnetic fields from objects such as magnetic toys, television, and speakers can change the setting in some models of programmable valves. 2,4,8,9 In a recent study, the maximum gauss level produced by an iPad was 170 G, which is less than the maximum gauss level found in any of our headphones. 7 Given that the magnetic field from a headphone is much closer to the valve, there is cause for concern regarding headphones.…”

Section: Discussionmentioning

confidence: 59%

Programmable shunts and headphones: Are they safe together?

Spader

Ratanaprasatporn

Morrison

et al. 2015

PED

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OBJECT Programmable shunts have a valuable role in the treatment of patients with hydrocephalus, but because a magnet is used to change valve settings, interactions with external magnets may reprogram these shunts. Previous studies have demonstrated the ability of magnetic toys and iPads to erroneously reprogram shunts. Headphones are even more ubiquitous, and they contain an electromagnet for sound projection that sits on the head very close to the shunt valve. This study is the first to look at the magnetic field emissions of headphones and their effect on reprogrammable shunt valves to ascertain whether headphones are safe for patients with these shunts to wear. METHODS In this in vitro study of the magnetic properties of headphones and their interactions with 3 different programmable shunts, the authors evaluated Apple earbuds, Beats by Dr. Dre, and Bose QuietComfort Acoustic Noise Cancelling headphones. Each headphone was tested for electromagnetic field emissions using a direct current gaussmeter. The following valves were evaluated: Codman Hakim programmable valve, Medtronic Strata II valve, and Aesculap proGAV. Each valve was tested at distances of 0 to 50 mm (in 5-mm increments) from each headphone. The exposure time at each distance was 1 minute, and 3 trials were performed to confirm results at each valve setting and distance. RESULTS All 3 headphones generated magnetic fields greater than the respective shunt manufacturer's recommended strength of exposure, but these fields did not persist beyond 5 mm. By 2 cm, the fields levels were below 20 G, well below the Medtronic recommendation of 90 G and the Codman recommendation of 80 G. Because the mechanism for the proGAV is different, there is no recommended gauss level. There was no change in gauss-level emissions by the headphones with changes in frequency and amplitude. Both the Strata and Codman-Hakim valves were reprogrammed by direct contact (distance 0 mm) with the Bose headphones. When a rotation component was added, all 3 headphones reprogrammed the Strata and Codman-Hakim valves at 0 mm. At all distances above 0 mm, the headphones did not affect the shunts. The proGAV valve was not affected by headphones at any distance. CONCLUSIONS Although all the headphones studied generated significant gauss fields at distances less than 5 mm, the programmable valve settings only changed at a distance of 0 mm (i.e., with direct contact). Given the subcutaneous location of the valve, the authors conclude that is highly unlikely that commercially available or customary headphones can contribute to the reprogramming of shunts.

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“…There are many sources of weak magnetic fields e.g. television, cell phones, or commercially available toy magnets that may influence a programmable valve in everyday life (13,7,1). The settings of the Strata valve including the Hakim valve were affected by magnetic flux densities of 6.0, 17.5, and, 40.0 mT, respectively.…”

Section: Case Descriptionmentioning

confidence: 99%

Programmable valve shunts: are they really better?

Kataria

Kumar²,

Mehta³

2010

Turkish Neurosurgery

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Programmable valve shunts allows selection of opening pressure of shunt valve. In the presented article, a unique complication pertaining to programmable shunts has been discussed. A 5-year-old boy who had tectal plate low grade glioma with obstructive hydrocephalus was managed with Codman programmable ventriculoperitoneal shunt. There was a spontaneous change in the opening pressure of the shunt valve leading to shunt malfunction. Routinely used household appliances produce a magnetic field strong enough to cause change in the setting of shunt valve pressure and may lead to valve malfunction. Other causes of programmable valve malfunction also discussed. MAnuSCRIPT Background: Programmable valve shunts are considered to be better than conventional fixed pressure valve shunts as they allow the selection of he opening pressure of the valve, which reduces the complications due to over/under drainage of the cerebrospinal fluid. Spontaneous changes in the set pressure, blockage and intrinsic malfunction of the valve are some causes of concern, apart from the cost.

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Alteration of the Pressure Setting of a Codman-Hakim Programmable Valve by a Television-Case Report-

Cited by 19 publications

References 11 publications

Maladjustment of programmable ventricular shunt valves by inadvertent exposure to a common hospital device

Maladjustment of programmable ventricular shunt valves by inadvertent exposure to a common hospital device

Programmable shunts and headphones: Are they safe together?

Programmable valve shunts: are they really better?

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