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Detection and Management of Delirium in the Neonatal Unit: A Case Series

Alan Groves1, Chani Traube2, Gabrielle Silver3

  • 1Departments of Pediatrics, and.

Pediatrics
|February 25, 2016
PubMed

Insights

Delirium is a common syndrome in critically ill children, often overlooked in the NICU. Early recognition and treatment with quetiapine may improve outcomes for infants with complex medical issues.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neonatalogy
  • Neuroscience

Background:

  • Delirium is a common syndrome in critically ill children, associated with longer hospital stays and poor long-term outcomes.
  • It is frequently underdiagnosed in the Neonatal Intensive Care Unit (NICU).

Observation:

  • Three infants in the NICU presented with classic delirium symptoms at corrected gestational ages of 4, 11, and 17 weeks.
  • These infants had complex medical conditions and were on multiple sedatives and analgesics.
  • Agitation was unresponsive to escalating doses of existing medications.

Findings:

  • All three infants showed improvement after treatment with quetiapine.
  • Quetiapine allowed for the reduction of other sedative and analgesic medications.
  • This suggests quetiapine as a potential treatment for delirium in this population.

Implications:

  • Increased vigilance for delirium in newborns may lead to earlier diagnosis and tailored interventions.
  • Further research is needed to establish the prevalence, risk factors, and optimal treatments for neonatal delirium.
  • This study highlights the potential role of atypical antipsychotics in managing neonatal agitation and delirium.

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