2024, Number 1
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Acta Pediatr Mex 2024; 45 (1)
Pediatric delirium in hospitalized patients
Vázquez MSB, García PS, Molina VD
Language: Spanish
References: 31
Page: 3-9
PDF size: 205.21 Kb.
ABSTRACT
Background: Delirium is a psychiatric medical condition, characterized by an
acute and fluctuating disturbance of alert state, and other cognitive manifestations.
Despite its high frequency in hospitalized pediatric patients, most of the research has
been limited to retrospective studies and there are no national prospective literature
reports on pediatric population.
Objective: Describe the frequency, clinical characteristics, morbidity and mortality
of delirium in hospitalized pediatric patients.
Materials and Methods: Observational, cross-sectional, prospective, analytical
study, in a sample of patients from 6 to 17 years old diagnosed with delirium by a child
psychiatrist from August 2020 to August 2021. Evaluation was performed using Cornell
and PAED delirium scales.
Results: Sample was constituted by 24 patients: 15 males and 9 females. Mean age
was 13 ± 3 years. Distribution by subtypes was: 10 (42%) patients with hypoactive
delirium, 9 (37%) patients with mixed delirium and 5 (21%). patients with hyperactive
delirium. Higher levels of C-Reactive Protein showed significant association with
severity of delirium. High frequency of adding risk factors was found.
Conclusions: High frequency of adding risk factors was found. Higher levels of
C-Reactive Protein showed significant association with severity of delirium.
REFERENCES
Ista ER, Chani M, Marjorie RN, Hennie MD. PhD5; on behalfof the Dutch Multidisciplinary Pediatric Delirium GuidelineGroup. Factors Associated With Delirium in Children: ASystematic Review and Meta-Analysis*. Pediatr Crit CareMed 2023; 10: 372-81.
Smith H, Williams S, Hughes C, Pandharipande P, et al.Pediatric delirium assessment, prevention, and management,Delirium: Acute Brain Dysfunction in the CriticallyIll. Nature 2020; 01: 35-65.
Dhingra S. Delirium in Pediatric Intensive Care Unit: Frequency,Causes, and Interventions. Indian J Crit Care Med2021; 25 (6): 620-621.
Semple D, Howlett MM, Strawbridge JD, Breatnach CV, etal. A systematic review and pooled prevalence of deliriumin critically ill children. Crit Care Med 2022; 50 (2): 317-28
Traube C, Silver G, Gerber LM, Kaur S, et al. Deliriumand mortality in critically ill children: Epidemiology andoutcomes of pediatric delirium. Crit Care Med 2017; 45(5): 891-8.
Siegel EJ, Traube C. Pediatric delirium: epidemiology andoutcomes: Epidemiology and outcomes. Curr Opin Pediatr2020; 32 (6): 743-9
Schieveld JNM, Janssen NJJF. Delirium in the pediatricpatient: On the growing awareness of its clinical interdisciplinaryimportance: On the growing awareness of itsclinical interdisciplinary importance. JAMA Pediatr 2014;168 (7): 595-6.
Slooter AJC, Otte WM, Devlin JW, Arora RC, et al. Updatednomenclature of delirium and acute encephalopathy:statement of ten Societies. Intens Care Med 2020; 46(5): 1020-2.
Holly C, Porter S, Echevarria M, Dreker M, et al. Originalresearch: Recognizing delirium in hospitalized children:A systematic review of the evidence on risk factors andcharacteristics. Am J Nurs 2018; 118 (4): 24-36.
Palmero-Picazo J, Lassard-Rosenthal J. Delirium: una revisiónactual. Aten Fam 2021; 28 (4): 284.
Hughes CG, Pandharipande PP, Wesley EE. Delirium: AcuteBrain Dysfunction in the Critically Ill. Cham, Suiza: SpringerNature; 2020;73-92.
Liviskie C, McPherson C, Luecke C. Assessment and managementof delirium in the pediatric intensive care unit: Areview. J Pediatr Intens Care 2023; 12 (2): 94-105.
Schieveld JNM, Strik JJMH. Biomarkers for pediatric deliriumsubtypes. Pediatr Crit Care Med 2020; 21 (11): 1008-9.
Silver GH, Kearney JA, Bora S, De Souza C, et al. A clinicalpathway to standardize care of children with delirium in pediatricinpatient settings. Hosp Pediatr 2019; 9 (11): 909-16.
Malas N, Brahmbhatt K, McDermott C, Smith A, et al.Pediatric delirium: Evaluation, management, and specialconsiderations. Curr Psy Rep 2017; 19 (9): 65.
Fong TG, Inouye SK. The inter-relationship between deliriumand dementia: the importance of delirium prevention.Nat Rev Neurol. 2022; 18 (10): 579-96.
Khan BA, Perkins AJ, Prasad NK, Shekhar A, et al. Biomarkersof delirium duration and delirium severity in the ICU.Crit Care Med 2020; 48 (3): 353-61.
Dechnik A, Mauer EA, Gerber LM, Traube C. C-reactiveprotein and procalcitonin levels may not predict deliriumin critically ill children. Pediatr Crit Care Med 2020; 21(11): e967-71.
Oh ES, Akeju O, Avidan MS, Cunningham C, et al. A roadmapto advance delirium research: Recommendations from theNIDUS Scientific Think Tank. Alzheimers Dement 2020; 16(5): 726-33.
Gu S, Couloures K. Pediatric delirium: A review of currentdiagnosis and management in the intensive care setting.Curr Pediatr Rep 2020; 8 (3): 80-5.
Delirium de emergencia en anestesia pediátrica. Rev ChilAnest 2022; 51 (4).
Russell PSS, Mammen PM, Shankar SR, Viswanathan SA,et al. Pediatric Anesthesia Emergence Delirium Scale: Adiagnostic meta-analysis. World J Clin Pediatr 2022; 11(2): 196-205.
Silver G, Kearney J, Traube C, Hertzig M. Delirium screeninganchored in child development: The Cornell Assessmentfor Pediatric Delirium. Palliat Support Care 2015; 13 (4):1005-11.
Schieveld JNM, van Zwieten JJ. From pediatrics to geriatrics:Toward a unified standardized screening tool for delirium: Athought experiment. Crit Care Med 2016; 44 (9): 1778-80.
Sikich N, Lerman J. Development and psychometric evaluationof the pediatric anesthesia emergence delirium scale.Anesthesiology 2004; 100 (5): 1138-45.
Torales J, Cesar, Navarro RE. Delirium pediátrico. An FacCienc Méd (Asunción) 2019; 52: 117-9.
Turkel SB, Jacobson J, Munzig E, Tavaré CJ. Atypical antipsychoticmedications to control symptoms of delirium inchildren and adolescents. J Child Adolesc Psychopharmacol.2012; 22 (2): 126-30.
Mody K, Kaur S, Mauer EA, Gerber LM, et al. Benzodiazepinesand development of delirium in critically ill children: Estimatingthe causal effect. Crit Care Med 2018; 46 (9): 1486-91.
Su X, Meng Z-T, Wu X-H, Cui F, et al. Dexmedetomidine forprevention of delirium in elderly patients after non-cardiacsurgery: a randomised, double-blind, placebo-controlledtrial. Lancet 2016; 388 (10054): 1893-902.
Manning AN, Bezzo LK, Hobson JK, Zoeller JE, et al. Dexmedetomidinedosing to prevent pediatric emergencedelirium. AANA J 2020; 88 (5): 359-64.
Castro REV de, Garcez FB, Avelino-Silva TJ. Patient care duringthe COVID-19 pandemic: do not leave delirium behind.Rev Bras Psiquiatr 2021; 43 (2): 127-8.