Post-Hemorrhagic Hydrocephalus — Infection — Clinical Pathway: ICU

Post-Hemorrhagic Hydrocephalus in Pre-Term Infants Clinical Pathway — N/IICU

Evaluation for Infection for Patients with Reservoir, External Ventricular Device, or VP Shunt

  • Infants with reservoirs who demonstrate the signs of infection below should be evaluated as per usual care standards. Those with a reservoir should have fluid sent from the reservoir for culture and also a cell count.
    • New and unexplained seizures
    • Fevers
    • Cardiovascular instability
  • While there is some debate regarding utility of cell counts with indwelling devices, published work has shown that white count can be interpreted for patients with a reservoir in the same way as you would for a patient in whom there is no reservoir. Antibiotic coverage while awaiting pending cultures should be broad, typically Vancomycin and Cefepime.

Reference

Predictive Value of Cerebrospinal Fluid Parameters in Neonates with Intraventricular Drainage Devices