Management of Hyperactive Delirium in the Pediatric Intensive Care Unit: Case Series of Three Young Children

Area of Science:

• Pediatric critical care medicine
• Neuroscience
• Pharmacology

Background:

• Children in the intensive care unit (ICU) face a high risk of delirium due to illness, treatments, and the ICU environment.
• Delirium in critically ill children can lead to severe complications.
• Non-pharmacologic interventions are the first line of treatment, but may be insufficient.

Observation:

• Three pediatric patients in the ICU presented with hyperactive delirium.
• These patients were at risk for life-threatening complications due to their delirium.
• Standard treatments for delirium were considered unsuccessful or insufficient for these cases.

Findings:

• A short course of atypical antipsychotic medications was administered to the three pediatric patients.
• The atypical antipsychotics were effective in treating the hyperactive ICU delirium.
• No significant adverse side effects were reported during the short treatment courses.

Implications:

• Atypical antipsychotics may be a viable treatment option for severe pediatric ICU delirium when other methods fail.
• Further research is warranted to establish the safety and efficacy of atypical antipsychotics for pediatric delirium.
• This case report highlights a potential therapeutic strategy for a challenging clinical problem in pediatric critical care.