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Risk factors of delirium in a paediatric intensive care unit: A prospective case series study

Ting-Ting Xu1, Yu-Cai Zhang1, Xiao-Fei Ye2

  • 1Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Nursing in Critical Care
|May 15, 2023
PubMed

Insights

Delirium is common in critically ill children, affecting 29.2% of patients. Key risk factors include mechanical ventilation, nervous system disease, and younger age, guiding targeted interventions.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neuroscience
  • Nursing Research

Background:

  • Delirium is a frequent complication in pediatric intensive care units (PICUs).
  • It leads to prolonged ICU stays, increased costs, and significant distress for critically ill children.
  • Identifying risk factors is crucial for developing effective nursing interventions.

Purpose of the Study:

  • To determine the incidence of delirium in a PICU population.
  • To identify independent risk factors associated with delirium in critically ill children.

Main Methods:

  • A prospective observational study was conducted in a PICU from February to July 2020.
  • Delirium was assessed using the Cornell Assessment of Paediatric Delirium (CAPD) and Richmond Agitation Sedation Scale.
  • Statistical analysis included univariate and multivariate logistic regression.

Main Results:

  • The incidence of delirium was 29.2% (92/315 patients).
  • Independent risk factors identified were mechanical ventilation, nervous system disease, developmental delay, benzodiazepine use, increased number of catheters, and younger age.
  • Hyperactive, hypoactive, and mixed delirium subtypes were observed.

Conclusions:

  • Delirium is a significant issue in PICUs with identifiable risk factors.
  • Mechanical ventilation, neurological conditions, developmental delay, benzodiazepines, catheter use, and younger age are key predictors.
  • Targeting these modifiable factors can inform strategies to reduce delirium incidence.
Abstract

Keywords:
deliriumpaediatric intensive care unitrisk factors

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