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Implementation and effectiveness of a delirium care protocol in Thai critically ill children

Chanapai Chaiyakulsil1, Thananya Thadahirunchot2

  • 1Division of Pediatric Critical Care, Department of Pediatrics, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

Acute and Critical Care
|December 5, 2023
PubMed

Insights

A new protocol reduced delirium duration in critically ill children with cardiovascular issues. Further research is needed to prevent long-term morbidity after pediatric intensive care unit discharge.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pediatric Neurology
  • Clinical Protocol Implementation

Background:

  • Delirium in critically ill children is linked to long-term negative health outcomes.
  • Identifying risk factors and effective interventions is crucial for improving pediatric patient care.
  • Current management strategies require evaluation for optimal efficacy.

Purpose of the Study:

  • To assess a new protocol's impact on pediatric delirium.
  • To evaluate changes in delirium prevalence and duration.
  • To identify risk factors associated with delirium in critically ill children.

Main Methods:

  • Chart review of critically ill children (1 month-15 years).
  • Cornell Assessment of Pediatric Delirium score used for diagnosis (≥9).
  • Comparison of pre- and post-protocol implementation phases; univariate and multivariate analyses for risk factors.

Main Results:

  • 120 children analyzed; 41.7% screened positive for delirium.
  • Younger age (<2 years), developmental delay, mechanical ventilation, and prolonged PICU stay (>7 days) were risk factors.
  • Protocol did not significantly alter overall delirium prevalence but reduced duration in cardiovascular cases.

Conclusions:

  • The new protocol effectively reduced delirium duration in children with cardiovascular conditions and post-cardiothoracic surgery.
  • Further research is necessary to develop strategies for delirium reduction and prevention of long-term morbidity post-PICU discharge.
Abstract

Keywords:
childrendeliriumintensive caremorbidity

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