[Development and treatment of delirium in critically ill children]

Marie Winther-Olesen1, Arash Afshari

  • 1Anæstesiologisk Klinik, Juliane Marie Centret, Rigshospitalet, Denmark. mariewo@gmail.com

Ugeskrift for Laeger
|February 2, 2012
PubMed

Insights

Paediatric delirium (PD) is a frequent, underdiagnosed condition in pediatric intensive care units, linked to poor outcomes. More research is vital for evidence-based recommendations on diagnosing and treating pediatric delirium.

Area of Science:

  • Neuroscience
  • Critical Care Medicine
  • Pediatrics

Context:

  • Delirium is a common yet often overlooked neuropsychiatric condition in pediatric critical care settings.
  • It frequently arises secondary to underlying medical conditions in children.
  • Paediatric delirium is associated with significant negative health consequences, including increased morbidity, mortality, and extended intensive care unit stays.

Purpose:

  • To introduce paediatric delirium (PD) to readers.
  • To review current knowledge on diagnostic tools, prognosis, and treatment strategies for PD.
  • To highlight the scarcity of existing literature and the urgent need for more clinical studies.

Summary:

  • This review provides an overview of paediatric delirium (PD), a prevalent neuropsychiatric disorder in pediatric intensive care.
  • It examines diagnostic methods, prognostic factors, and therapeutic interventions for PD.
  • The review emphasizes that current literature on PD is limited, underscoring the necessity for further clinical research.

Impact:

  • Increased recognition and diagnosis of paediatric delirium.
  • Improved patient outcomes and reduced healthcare costs associated with PD.
  • Foundation for future evidence-based guidelines and clinical practice improvements in managing paediatric delirium.

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...