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Delirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit

Rita V Alvarez1, Claire Palmer2, Angela S Czaja3

  • 1Section of Critical Care, Department of Pediatrics, Medical College of Wisconsin, Wauwatosa, WI.

The Journal of Pediatrics
|February 4, 2018
PubMed

Insights

Delirium is common in pediatric cardiac intensive care unit patients, affecting 57%. Younger age, mechanical ventilation, and benzodiazepine use were associated risk factors, leading to longer hospital stays.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neuroscience
  • Cardiology

Background:

  • Delirium is a serious complication in adult cardiac surgery patients.
  • Its impact on children with critical cardiac disease is not well understood.

Purpose of the Study:

  • To determine the incidence, risk factors, and characteristics of delirium in a pediatric cardiac intensive care unit (CICU).

Main Methods:

  • A single-center prospective observational study was conducted.
  • Ninety-nine patients aged 21 years or younger in the CICU were screened for delirium using the Cornell Assessment for Pediatric Delirium (CAPD) every 12 hours.

Main Results:

  • The incidence of delirium was 57%, with a median onset of 1 day.
  • Delirious children were younger, required longer mechanical ventilation and cardiopulmonary bypass times, and had a longer CICU stay.
  • Multivariable analysis revealed significant associations between delirium and younger age, mechanical ventilation, and benzodiazepine use.

Conclusions:

  • Delirium is prevalent in pediatric CICU patients and correlates with increased length of stay.
  • Targeting modifiable risk factors, such as benzodiazepine administration, may offer opportunities for delirium prevention.
Abstract

Keywords:
Cornell Assessment for Pediatric DeliriumICU deliriumadolescentbenzodiazepinescardiopulmonary bypasschildreninfant

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