Effect of Body Position on Cerebrospinal Fluid Pressure
Author Information
Author(s): Sithinamsuwan Pasiri, Sithinamsuwan Nakorn, Tejavanija Sirakarn, Udommongkol Chesda, Nidhinandana Samart
Primary Institution: Phramongkutklao Hospital and College of Medicine
Hypothesis
Older people would be more relaxed and those with a lower BMI would be less likely to have increased intra-abdominal pressure.
Conclusion
Flexed opening pressure should not be routinely used in clinical practice as it can falsely diagnose raised intracranial pressure.
Supporting Evidence
- Mean pressures for flexed and relaxed positions were 178.54 and 160.52 mmH2O respectively.
- R-OP > 180 mmH2O plus clinical signs were indicators of raised intracranial pressure.
- Sensitivity and specificity of F-OP > 180 mmH2O for increased intracranial pressure were 95.7% and 83.3%, respectively.
- Increased intracranial pressure was significantly over-diagnosed in 10 out of 60 cases when using F-OP > 180 mmH2O.
- The equation R-OP = 0.885 × F-OP was derived to estimate relaxed opening pressure from flexed opening pressure.
Takeaway
This study looked at how lying in different positions affects the pressure of fluid in the spine, finding that one position can make it seem like there is a problem when there isn't.
Methodology
Patients underwent lumbar puncture in both flexed and relaxed positions to measure cerebrospinal fluid opening pressure.
Potential Biases
Potential bias in diagnosing raised intracranial pressure based on the position of the patient.
Limitations
The study may not account for all factors affecting cerebrospinal fluid pressure.
Participant Demographics
45 males (54.2%) and 38 females (45.8%) with a mean age of 48.7 years.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: 12.66–23.39
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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