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Delirium and Cognitive Dysfunction in and Beyond the Pediatric Intensive Care Unit.
Sage E Lachman1, Margaret J Klein2, Anita Hamilton2
1Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
Pediatric Neurology
|November 1, 2025
Summary
Pediatric intensive care unit (PICU) admissions show high rates of cognitive dysfunction. Delirium during PICU stays did not predict long-term cognitive deficits in children.
Area of Science:
- Pediatric critical care medicine
- Neuroscience
- Developmental psychology
Background:
- Delirium is common in pediatric intensive care units (PICUs).
- PICU admission is linked to cognitive dysfunction in children.
- Delirium may negatively impact academic performance.
Purpose of the Study:
- To determine the incidence of delirium in children admitted to the PICU.
- To investigate the relationship between delirium and long-term cognitive dysfunction in children.
Main Methods:
- Observational study in a pediatric intensive care unit.
- 146 children aged 5-17 years were enrolled.
- Delirium screening, cognitive assessments (Children's Memory Scale), and executive function evaluations were performed during hospitalization and at 3-month follow-up.
Main Results:
- Approximately one-third of children experienced cognitive dysfunction at 3 months post-PICU admission.
- 37.3% of children screened positive for delirium during their PICU stay.
- No association was found between delirium burden and cognitive dysfunction at any time point.
- Children showed persistent cognitive deficits from hospitalization to follow-up.
Conclusions:
- Pediatric intensive care unit admissions are associated with significant rates of cognitive dysfunction.
- In-hospital cognitive dysfunction, but not delirium burden, predicted later cognitive deficits.
- Further research is needed to understand the factors contributing to cognitive dysfunction after PICU stays.
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