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The Challenges of Diagnosing, Managing, and Preventing Pediatric Delirium

Juliana Patrícia Chaves de Almeida1,2, Yu Kawai3, Arnaldo Prata-Barbosa4

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, Federal Hospital of Lagoa, Rio de Janeiro 22470-050, Brazil.

Children (Basel, Switzerland)
|July 29, 2025
PubMed

Insights

Pediatric delirium (PD) is underdiagnosed in children, but new bedside tools like CAPD and pCAM-ICU aid early recognition. Prompt identification and intervention are crucial for critically ill children to reduce negative outcomes.

Area of Science:

  • Pediatric Intensive Care Medicine
  • Neuropsychiatry
  • Critical Care

Background:

  • Pediatric delirium (PD) is a significant neuropsychiatric syndrome in pediatric intensive care units (PICUs).
  • PD is associated with adverse outcomes, including mortality and long-term cognitive impairment.
  • Underdiagnosis of PD stems from challenges in assessing pediatric cognition and consciousness.

Purpose of the Study:

  • To provide a comprehensive review of pediatric delirium.
  • To discuss diagnostic tools and management strategies for PD in children aged 0-21.
  • To highlight the importance of early identification and intervention.

Main Methods:

  • Narrative review of existing literature on pediatric delirium.
  • Exploration of historical background, epidemiology, risk factors, and pathophysiology.
  • Analysis of validated bedside screening tools (CAPD, psCAM-ICU, pCAM-ICU, SOS-PD).

Main Results:

  • Several validated bedside tools (CAPD, psCAM-ICU, pCAM-ICU, SOS-PD) improve PD recognition.
  • Non-pharmacological interventions (environmental, family-centered care) are key.
  • Pharmacological management should be cautious and selective.

Conclusions:

  • Early and accurate diagnosis of PD is essential for critically ill children.
  • Integrated strategies involving screening tools and multimodal interventions improve outcomes.
  • Addressing PD is vital to mitigate morbidity and mortality in pediatric critical care.

Keywords:
deliriumdiagnosismanagementpediatric deliriumpediatric intensive care unitprevention

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