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Management of pediatric delirium in critical illness: a practical update

S G Van Tuijl1, Y J Van Cauteren, T Pikhard

  • 1Division Child and Adolescent Psychiatry, Department of Psychiatry and Psychology, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands - jan.schieveld@mumc.nl.

Minerva Anestesiologica
|April 26, 2014
PubMed

Insights

Pediatric delirium (PD) is a critical brain dysfunction in the pediatric intensive care unit (PICU). This review offers an update on its diagnosis and management, including pharmacological and non-pharmacological treatments.

Area of Science:

  • Critical Care Medicine
  • Pediatric Neurology
  • Neuroscience

Background:

  • Pediatric delirium (PD) is an acute brain dysfunction frequently observed in pediatric intensive care units (PICUs).
  • There is increasing recognition of its significant clinical and interdisciplinary importance.
  • PD represents a specific manifestation of acute emotional and/or behavioral disturbances in children.

Purpose of the Study:

  • To describe the three clinical presentations of pediatric delirium.
  • To evaluate the differential diagnosis for PD in the PICU setting.
  • To provide a practical update on pharmacological and non-pharmacological treatments for PD based on current literature and expert consensus.

Main Methods:

  • Literature review of recent studies and expert opinions on pediatric delirium.
  • Analysis of clinical presentations and differential diagnoses.
  • Development of an interdisciplinary flowchart for diagnosis and management.

Main Results:

  • Detailed description of the three main clinical presentations of PD.
  • Evaluation of key differential diagnoses to distinguish PD from other conditions.
  • Concise update on evidence-based pharmacological and non-pharmacological treatment strategies.

Conclusions:

  • Effective management of PD requires an interdisciplinary approach.
  • The provided flowchart aids in diagnosing and managing acute behavioral disturbances, with PD as a focus.
  • This review serves as a practical guide for clinicians managing PD in the PICU.

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