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| INSTRUCTIONS FOR USE
GB
FUNCTION OF THE VALVE
The operating principle of the paediGAV is illus-
trated in fig. 3 and fig. 4.
Fig. 3 a shows the paediGAV in a horizontal
position. The ball-cone unit is closed and the
drainage is blocked. In fig. 3 b, the paediGAV
is shown when it is open. The increased IVP of
the patient overcomes the spring force, which
otherwise would keep the ball-cone unit closed.
The closing ball is pushed away from the cone
seal and a gap opens for fluid drainage. The
gravitational unit is always open in the horizon-
tal position and does not present any resistance
to the drainage flow.
ball-cone unit
a)
b)
Fig. 3: paediGAV in horizontal position
a) closed b) open
As soon as the patient raises to a vertical po-
sition, the gravitational unit closes and the drai-
nage is interrupted (fig. 4 a). In this position, the
sum of the IVP and the hydrostatic pressure
surpasses the spring force of the ball-cone unit.
Therefore this valve is open now. But only when
the sum of the IVP and the hydrostatic pressure
exceeds the gravitational force on the tantalum
ball in the gravitational unit, the drainage path is
open again (fig. 4 b).
a)
b)
Fig. 4: paediGAV in a vertical position
a) closed b) open
16
gravitational unit
SELECTING THE APPROPRIATE VALVE
The paediGAV operates in different modes de-
pending on the physical position of the patient.
It features two different opening pressures, one
for the patient in a horizontal position and one
for a vertical position.
Percutaneous readjustments of the valve ope-
ning pressure become unnecessary through
this design, as a higher opening pressure in the
vertical position counteracts any unintentional
overdraining, while the lower opening pressure
required for when the patient is lying down rules
out any underdrainage.
Horizontal position:
For the horizontal position, two different ope-
ning pressure settings are available (4 and 9
cmH
O). Selection of the appropriate pressure
2
rating should be made in accordance with indi-
cation (age of the patient).
Vertical position:
The opening pressure for the vertical body
position depends upon the size of the patient
(hydrostatic parameter). If an infant is being tre-
ated, a low pressure rating should be selected.
If, on the other hand, a larger child is being tre-
ated, a paediGAV with a higher pressure rating
should be applied. (see recommendation of
pressure settings at www.miethke.com)
READING THE PRESSURE SETTING FROM
AN X-RAY IMAGE
Each paediGAV is calibrated under strict quality
control. The following pressure combinations
are available:
Opening pressure
horizontal
vertical
4 cmH
O
24 cmH
O
2
2
9 cmH
O
24 cmH
O
2
2
9 cmH
O
29 cmH
O
2
2
4 cmH
O
14 cmH
O
2
2
4 cmH
O
19 cmH
O
2
2
9 cmH
O
19 cmH
O
2
2
paediGAV
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