Acquired Brain Injury in the Pediatric Intensive Care Unit: Special Considerations for Delirium Protocols

Area of Science:

• Pediatric critical care medicine
• Pediatric neurology
• Neuroscience

Background:

• Delirium and acquired brain injury (ABI) present overlapping symptoms in pediatric patients.
• Standardized screening and management for delirium are increasingly implemented in pediatric intensive care units.

Purpose of the Study:

• To highlight symptom overlap between delirium and ABI in children.
• To examine treatment similarities and differences, focusing on antipsychotic effects on brain injury recovery.

Main Methods:

• Literature review focusing on pediatric delirium and ABI.
• Analysis of treatment strategies, including pharmacologic and non-pharmacologic interventions.
• Examination of evidence regarding adverse effects of antipsychotics on brain injury recovery.

Main Results:

• Significant overlap exists between symptoms of delirium and ABI in children.
• Antipsychotic medications may have adverse effects on recovery from pediatric brain injury.
• Current treatment approaches may not be fully optimized for children with ABI.

Conclusions:

• An interdisciplinary educational approach is crucial for recognizing delirium and ABI overlap in pediatric intensive care.
• Development of specialized treatment protocols for pediatric ABI is needed.
• Optimized care for children with ABI requires a combination of non-pharmacologic and pharmacologic strategies, avoiding less preferred treatments.