Monitoring and Management of Pediatric Patients with VP Shunts
Special Considerations
- Careful monitoring for signs of both shunt malfunction and seizures is essential, as either can present with altered neurological status, according to Anaesthesia guidelines 1
- Monitoring of vital signs and mean arterial pressure is crucial in children with brain injury or after neurosurgical procedures, with specific targets based on age, such as 40-60 mmHg for children less than 3 months, 45-75 mmHg for children 3 months-1 year, 50-90 mmHg for children 1-5 years, 60-90 mmHg for children 6-11 years, and 65-95 mmHg for children 12-14 years, as recommended by Anaesthesia 1
Quality Improvement Metrics
- Monitoring for seizures should be included in the post-operative care of children with VP shunts, as suggested by Anaesthesia 1
- Documentation of neurological status, including pupillary size and reaction, is essential during follow-up of shunted patients, according to Anaesthesia guidelines 1
- Regular blood glucose monitoring is important as young children are prone to hypoglycemia, which can lower seizure threshold, as noted by Anaesthesia 1