TY - JOUR
T1 - Bradycardia without hypertension; is it a common clinical presentation of ventriculoperitoneal shunt malfunction in pediatric patients?
AU - Marmor, Itay
AU - Carbell, Gary
AU - Koplowitz, Jake
AU - Roth, Jonathan
AU - Shimoni, Nir
AU - Constantini, Shlomo
AU - Rimon, Ayelet
AU - Glatstein, Miguel Marcelo
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: Mechanical shunting of cerebrospinal fluid is an effective treatment for hydrocephalus. Some studies suggest that bradycardia without hypertension may also be observed in ventriculoperitoneal (VP) shunt malfunction; however, in our experience, this is not a common presenting sign. Objective: The aim of this studywas to evaluatewhether bradycardiawithout hypertension was a common sign in patients presenting to the pediatric emergency department (ED) with a VP shunt malfunction. Methods: A retrospective observational study, from May 2006 to April 2015, which included a randomsample of children admitted to the EDwith clinical features suggestive of possible VP shunt malfunction. Control patientswere defined as thosewho arrived at our EDwith suspected VP shunt malfunction that was later ruled out on further workup. Results: A total of 65 patients were included in this study. A significantly greater number of patients with a confirmed shunt pathology presented with vomiting (P = 0.01) and lethargy/apathy (P = 0.01). In the control group, a significantly greater number of patients presented with fever (P = 0.004) and seizures (P = 0.02). The number of patients presenting with bradycardia was not significantly different between the shunt pathology and control groups (P > 0.05). Conclusions: Bradycardia is not a common presentation in patients with VP shunt malfunction. Bradycardia is often recognized as a significant sign; however, it is one of the last presenting signs. Educating patients about the early signsmust be considered as part of the treatment forVP shuntmalfunction.
AB - Background: Mechanical shunting of cerebrospinal fluid is an effective treatment for hydrocephalus. Some studies suggest that bradycardia without hypertension may also be observed in ventriculoperitoneal (VP) shunt malfunction; however, in our experience, this is not a common presenting sign. Objective: The aim of this studywas to evaluatewhether bradycardiawithout hypertension was a common sign in patients presenting to the pediatric emergency department (ED) with a VP shunt malfunction. Methods: A retrospective observational study, from May 2006 to April 2015, which included a randomsample of children admitted to the EDwith clinical features suggestive of possible VP shunt malfunction. Control patientswere defined as thosewho arrived at our EDwith suspected VP shunt malfunction that was later ruled out on further workup. Results: A total of 65 patients were included in this study. A significantly greater number of patients with a confirmed shunt pathology presented with vomiting (P = 0.01) and lethargy/apathy (P = 0.01). In the control group, a significantly greater number of patients presented with fever (P = 0.004) and seizures (P = 0.02). The number of patients presenting with bradycardia was not significantly different between the shunt pathology and control groups (P > 0.05). Conclusions: Bradycardia is not a common presentation in patients with VP shunt malfunction. Bradycardia is often recognized as a significant sign; however, it is one of the last presenting signs. Educating patients about the early signsmust be considered as part of the treatment forVP shuntmalfunction.
KW - Bradycardia
KW - Malfunction
KW - Ventriculoperitoneal shunt
UR - http://www.scopus.com/inward/record.url?scp=85120980834&partnerID=8YFLogxK
U2 - 10.1097/PEC.0000000000002049
DO - 10.1097/PEC.0000000000002049
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C2 - 32011556
AN - SCOPUS:85120980834
SN - 0749-5161
VL - 37
SP - E817-E820
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 12
ER -