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A case of infant delirium in the neonatal intensive care unit
L E Edwards1, L B Hutchison2, C D Hornik3
1Department of Pediatrics, Division of Neonatology, Duke University Medical Center, Durham, NC, USA.
Insights
Infant delirium in neonatal intensive care is often missed. Risperidone, an atypical antipsychotic, helped wean a mechanically ventilated infant from sedatives and analgesics without adverse effects.
Area of Science:
- Neonatal Intensive Care Medicine
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Infant delirium is an under-recognized condition in neonatal intensive care units (NICUs).
- Early identification and treatment are crucial to minimize associated morbidities.
- Prolonged mechanical ventilation and sedative/analgesic use are risk factors for delirium in infants.
Abstract:
Infant delirium is an under-recognized clinical entity in neonatal intensive care, and earlier identification and treatment could minimize morbidities associated with this condition. We describe a case of a 6-month-old former 32 weeks gestation infant undergoing a prolonged mechanical ventilation course diagnosed with delirium related to the combination of his underlying illness and the use of multiple sedative and analgesic medications. Initiation of the atypical antipsychotic risperidone allowed for weaning from continuous infusions of benzodiazepines and opiods, and lower dosages of bolus-dosed sedation and analgesics. The patient experienced no adverse side effects from use of this neuroleptic.
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