C-Reactive Protein and Procalcitonin Levels May Not Predict Delirium in Critically Ill Children

Area of Science:

• Pediatric critical care medicine
• Neuroscience
• Clinical pathology

Background:

• Delirium is a common complication in critically ill children, associated with adverse outcomes.
• Inflammatory markers like C-reactive protein (CRP) and procalcitonin (PCT) have shown predictive value for delirium in adult populations.
• The role of these inflammatory markers in pediatric delirium remains less understood.

Purpose of the Study:

• To investigate the relationship between C-reactive protein and procalcitonin levels and the diagnosis of delirium in critically ill children.
• To determine if these inflammatory markers can predict the development of delirium in a pediatric intensive care unit (PICU) population.

Main Methods:

• A retrospective cohort study was conducted in a tertiary care urban academic PICU.
• Patients aged 0-21 years admitted between January 1, 2015, and December 31, 2017, were included.
• Delirium and coma were assessed using the Cornell Assessment of Pediatric Delirium; CRP and PCT levels were analyzed.

Main Results:

• Seven hundred thirty-four patients were enrolled; 37% experienced delirium on at least one study day.
• C-reactive protein levels showed no relationship with delirium or coma.
• Procalcitonin levels were highest on days with coma and lowest on days with delirium, but no statistically significant relationship was found with any delirium subtype.

Conclusions:

• Contrary to findings in adults, this study found no association between C-reactive protein or procalcitonin levels and the development of delirium in critically ill children.
• These inflammatory markers may not be reliable predictors of delirium in the pediatric intensive care setting.