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Recognition and Management of Delirium in the Neonatal Intensive Care Unit: Case Series From a Single-Center Level IV
Stacey Dornette1, Stephen Deptola2, Brianna Hemmann2
1Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital, Cincinnati, OH, USA.
Insights
Delirium in neonates is often missed. This study explored quetiapine as a treatment for delirium in medically complex infants, offering guidance for future management.
Area of Science:
- Neonatal medicine
- Pediatric neurology
- Pharmacology
Background:
- Delirium in neonates and children is frequently underdiagnosed due to challenges in behavioral assessment and lack of awareness.
- Distinctive symptoms and limited data hinder effective pharmacologic treatment strategies for pediatric delirium.
- There is a growing recognition of delirium in neonates, necessitating evidence-based treatment guidelines.
Purpose of the Study:
- To present the clinical experience of using quetiapine for treating delirium in medically complex neonates.
- To propose a monitoring and treatment approach for neonatal and infant delirium based on literature and expert opinion.
Main Methods:
- Retrospective single-center case series involving 9 medically complex neonates.
- Extensive literature review on neonatal delirium and its management.
- Incorporation of expert opinion and institutional experience.
Main Results:
- Experience using quetiapine in 9 medically complex neonates with delirium is detailed.
- The study provides a foundation for a proposed approach to managing neonatal delirium.
Conclusions:
- Quetiapine was used to treat delirium in a small cohort of medically complex neonates.
- The findings support the need for further research and development of standardized approaches for neonatal delirium management.
Abstract:
Delirium often goes unrecognized in neonates and children because of lack of experience in evaluating behavior and cognition, insufficient awareness of the prevalence, and nondistinctive symptoms in this population. Although there are increasing reports of the presence of delirium in neonates, there are little data to guide the pharmacologic treatment in this population. In this retrospective single-center case series, we present our experience using quetiapine to treat delirium in 9 medically complex neonates. Based on an extensive literature review, expert opinion, and institutional experience, we propose an approach for monitoring and treating delirium in neonates and infants.
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