Delirium and Associated Risk Factors in Mechanically Ventilated Children: A Prospective Observational Study

The purpose of this study was to investigate the prevalence and risk factors of delirium in children receiving mechanical ventilation (MV) admitted to the pediatric intensive care unit. A prospective observational study was conducted, enrolling 160 critically ill children aged 29 days to 18 years who received MV for more than 24 hr between August 2021 and August 2023. Delirium was assessed using the Cornell Assessment of Pediatric Delirium. Demographic, disease-related, and treatment-related characteristics were collected from electronic medical records by staff nurses. The incidence of delirium in children with MV was 83.8%. The median duration of MV at the onset of delirium was 1.5 (interquartile range: 0.5, 3.0) days, and according to the day of extubation, 74.6% of delirium cases first occurred ≥ 24 hr before extubation. Binary logistic regression analyses revealed that the independent risk factors of delirium in critically ill children with MV included age ≤ 5 years, physical restraints, pediatric sequential organ failure assessment score, and lower pulse oximetry oxygen saturation (SpO₂). This study may help develop intervention strategies to reduce the incidence of delirium in critically ill children with MV by targeting related risk factors.