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Updated: Jun 9, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Current Evidence Regarding the Evaluation and Management of Neonatal Delirium
Olivia Ruth1, Sheri Tomajko2, Emman Dabaja3
1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Michigan Mott Children's Hospital, Ann Arbor, MI, USA. oruth@med.umich.edu.
Insights
Neonatal intensive care unit (NICU) infants are at high risk for delirium. Current evidence for managing infant delirium in the NICU is limited, necessitating further research for best practices.
Area of Science:
- Neonatal care
- Pediatric intensive care
- Neuroscience
Background:
- Infants in the neonatal intensive care unit (NICU) face unique risks for delirium.
- Limited research exists specifically for NICU delirium, forcing reliance on data from older children.
Purpose of the Study:
- To review existing literature on delirium in newborns and infants within the NICU setting.
- To identify evidence gaps and guide clinical management.
Main Methods:
- A rigorous review of scientific literature was conducted.
- Focus was placed on studies relevant to newborns and infants in critical care.
Main Results:
- Delirium incidence in NICU infants may be as high or higher than in other populations.
- A significant lack of validated delirium assessment tools for the NICU setting was identified.
- Evidence for effective evaluation and management strategies in the NICU is scarce.
Conclusions:
- More NICU-specific research is crucial to establish evidence-based guidelines.
- Developing and validating assessment tools for NICU delirium is a priority.
- Consensus on best practices for NICU delirium management requires further investigation.
Purpose Of Review:
Newborns and infants in the neonatal intensive care unit (NICU) may be at uniquely high risk of developing delirium. Because there is a dearth of NICU-focused literature, providers must rely on evidence derived from older children and infants in other care settings to guide management. The literature was rigorously reviewed to highlight evidence specific to newborns and infants and is summarized here.
Recent Findings:
Delirium likely occurs in newborns and infants at similar or higher rates than what is seen in other care settings. Recent literature calls particular attention to the lack of assessment tools validated in a NICU setting. Evidence for the evaluation and management of delirium in the NICU is lacking. More study specific to the NICU is needed to build consensus toward best practice.
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