Incidence and factors associated with delirium in critically ill patients under 5 years old

Area of Science:

• Pediatric critical care medicine
• Neuroscience
• Child psychology

Background:

• Delirium is a common complication in pediatric intensive care units (PICUs).
• Early identification and management of delirium are crucial for improving patient outcomes.
• Limited data exists on the incidence and specific risk factors for delirium in young children hospitalized in the PICU.

Purpose of the Study:

• To determine the incidence of delirium in children under 5 years old admitted to the PICU.
• To identify factors associated with the presence of delirium in this pediatric population.

Main Methods:

• Prospective observational study utilizing convenience sampling.
• Inclusion of 52 patients aged 6 months to 5 years hospitalized in the PICU.
• Application of the Spanish version of the Preschool Confusion Assessment Method for the intensive care units (PSCAM-ICU) instrument.
• Bivariate analysis to identify potential risk factors.

Main Results:

• The incidence of delirium was 71.1% in children under 5 in the PICU, predominantly hypoactive.
• Children with delirium were more likely to be female, younger (average 31 months), and have lower weight.
• Potential risk factors included longer PICU stays, mechanical ventilation, higher CO2 pressure, lower O2 pressure, orotracheal intubation, and sedative/analgesic medication.

Conclusions:

• Delirium is highly prevalent in young children in the PICU, particularly in younger girls and lower-weight children.
• Identified risk factors align with existing literature, emphasizing the need for vigilance.
• Healthcare staff in PICUs can use these findings to proactively prevent or promptly identify delirium, thereby reducing its impact.