BACKGROUND Hydrocephalus is managed by surgically implanting flow-diversion technologies such as differential pressure valves and antisiphoning devices; however, such hardware is prone to failure. Extensive research has tested them in flow-controlled settings using saline or de-aerated water, yet little has been done to validate their performance in a setting recreating physiologically relevant parameters, including intracranial pressures, cerebrospinal fluid (CSF) protein content, and body position. OBJECTIVE To more accurately chart the episodic drainage characteristics of flow-diversion technology. A gravity-driven benchtop model of flow was designed and tested continuously during weeks-long trials. METHODS Using a hydrostatic pressure gradient as the sole driving force, interval flow rates of 6 valves were examined in parallel with various fluids. Daily trials in the upright and supine positions were run with fluid output collected from distal catheters placed at alternating heights for extended intervals. RESULTS Significant variability in flow rates was observed, both within specific individual valves across different trials and among multiple valves of the same type. These intervalve and intravalve variabilities were greatest during supine trials and with increased protein. None of the valves showed evidence of overt obstruction during 30 d of exposure to CSF containing 5 g/L protein. CONCLUSION Day-to-day variability of ball-in-cone differential pressure shunt valves may increase overdrainage risk. Narrow-lumen high-resistance flow control devices as tested here under similar conditions appear to achieve more consistent flow rates, suggesting their use may be advantageous, and did not demonstrate any blockage or trend of decreasing flow over the 3 wk of chronic use.

中文翻译：

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使用新型台式分流模型评估脑脊液蛋白质含量对压差阀和反虹吸装置性能的影响

背景技术脑积水是通过手术植入分流技术，如压差阀和反虹吸装置；然而，这样的硬件很容易出现故障。广泛的研究已经在使用盐水或脱气水的流量控制环境中对它们进行了测试，但很少有人在重新创建生理相关参数的环境中验证它们的性能，包括颅内压、脑脊液 (CSF) 蛋白质含量和身体位置. 目的更准确地描绘分流技术的情景排水特性。在长达数周的试验中，我们设计并持续测试了重力驱动的台式流动模型。方法 使用静水压力梯度作为唯一驱动力，6 个阀门的间隔流速与各种流体平行进行了检查。每天在直立和仰卧位进行试验，从以交替高度放置的远端导管收集液体输出，以延长间隔。结果 观察到流速的显着变化，无论是在不同试验中的特定单个阀门内，还是在同一类型的多个阀门之间。这些间隔和瓣内变异在仰卧试验和蛋白质增加时最大。在暴露于含有 5 g/L 蛋白质的 CSF 30 天期间，没有一个瓣膜显示出明显阻塞的迹象。结论 圆锥球压差分流阀的日常变化可能会增加过度排水的风险。