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Risk Factors for the Development of Postoperative Delirium in Pediatric Intensive Care Patients

Jochen Meyburg1, Mona-Lisa Dill1, Rebecca von Haken2

  • 1Department of General Pediatrics, University Children's Hospital, Heidelberg, Germany.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|July 31, 2018
PubMed

Insights

Postoperative pediatric delirium is common, affecting 66% of children after major surgery. Risk factors include younger age, invasive devices, infections, and inhalational anesthesia.

Area of Science:

  • Pediatric critical care medicine
  • Anesthesiology
  • Neuroscience

Background:

  • Postoperative delirium is a significant concern in pediatric intensive care units (PICUs).
  • Identifying risk factors is crucial for developing preventative strategies.

Purpose of the Study:

  • To determine and quantify risk factors for postoperative pediatric delirium.
  • To establish a baseline for future delirium prevention and treatment strategies in children.

Main Methods:

  • Prospective cohort study in a tertiary care academic medical center in Germany.
  • Screened 93 children (0-17 years) after major elective surgery for delirium using the Cornell Assessment of Pediatric Delirium over 5 days.
  • Collected demographic and clinical data from anesthesia initiation.

Main Results:

  • 66% of patients (61/93) experienced delirium, with younger children showing more pronounced symptoms.
  • Risk factors identified include younger age, invasive catheters, respiratory devices, infections, and inhalational anesthesia.
  • Delirium was associated with longer mechanical ventilation duration and differences in medication cumulative doses, independent of disease severity.

Conclusions:

  • High prevalence of postoperative delirium in pediatric surgical patients.
  • Identified key perioperative risk factors that can inform clinical practice.
  • Data supports the development of targeted interventions to reduce pediatric delirium.
Abstract

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