Practice Variability in Screening and Treating Pediatric Critical Illness Delirium: Survey

Area of Science:

• Pediatric Critical Care Medicine
• Neuroscience
• Clinical Practice Guidelines

Background:

• Best practices for pediatric delirium (PD) screening and treatment remain undefined.
• Current recommendations are based on limited studies and adult data.
• Standardized approaches are lacking in pediatric critical care settings.

Purpose of the Study:

• To survey Pediatric Critical Care Medicine fellowship directors regarding PD screening and treatment.
• To identify current practices in large academic medical centers in the United States.
• To highlight the need for standardized national guidelines for pediatric delirium.

Main Methods:

• Cross-sectional survey of Pediatric Critical Care Medicine fellowship directors.
• Data collection on screening tools and pharmacologic treatments for PD.
• Analysis of reported practices across major US academic medical centers.

Main Results:

• Significant variability exists in PD screening and treatment protocols.
• The Cornell Assessment of Pediatric Delirium is the most frequently used screening tool.
• Quetiapine is the most commonly utilized pharmacologic agent for PD treatment.

Conclusions:

• There is a high degree of heterogeneity in pediatric delirium management.
• A national guideline is essential to standardize screening, prevention, and treatment of PD.
• Standardization will improve patient care and outcomes in pediatric critical care.