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A Systematic Review and Pooled Prevalence of Delirium in Critically Ill Children

Diarmaid Semple1,2, Moninne M Howlett1,2, Judith D Strawbridge1

  • 1Pharmacy Department, Children's Health Ireland, Crumlin, Dublin, Ireland.

Critical Care Medicine
|August 13, 2021
PubMed

Insights

Pediatric delirium, a common condition in critical care, affects 34% of children. Hypoactive delirium is most prevalent, and risk factors include sedative medications and surgery, impacting clinical outcomes.

Area of Science:

  • Neuroscience
  • Critical Care Medicine
  • Pediatric Health

Background:

  • Pediatric delirium is a neuropsychiatric disorder affecting cerebral functioning in critically ill children.
  • It can manifest as hypoactive, hyperactive, or mixed subtypes.
  • Understanding its prevalence and risk factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To estimate the pooled prevalence of pediatric delirium in intensive care settings.
  • To identify modifiable and nonmodifiable risk factors associated with pediatric delirium.
  • To explore the association between pediatric delirium and clinical outcomes.

Main Methods:

  • A systematic review and meta-analysis of studies on pediatric delirium prevalence.
  • Searches were conducted in PubMed, EMBASE, and CINAHL databases.
  • Inclusion criteria focused on studies using validated tools to estimate prevalence in pediatric intensive care units.

Main Results:

  • The pooled prevalence of pediatric delirium is estimated at 34% among pediatric critical care admissions.
  • Hypoactive delirium was the most common subtype (46-81%).
  • Risk factors included sedative doses, mechanical ventilation, and cardiothoracic surgery, associated with increased length of stay and mortality.

Conclusions:

  • Pediatric delirium is a significant issue in critical care with a high prevalence.
  • Risk factors like sedative use and specific surgeries are linked to adverse outcomes.
  • Further multi-institutional and longitudinal studies are needed to fully understand its impact and management.
Abstract

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