Clinical characteristics, prevalence, and factors related to delirium in children of 5 to 14 years of age admitted to intensive care

To evaluate the clinical characteristics, prevalence and factors associated with delirium in critical patients from 5 to 14 years of age. An analytical, cross-sectional observational study was made. Delirium was assessed with the Pediatric-Confusion Assessment Method for the Intensive Care Unit (pCA...

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Bibliographic Details
Published in:	Medicina intensiva Vol. 43; no. 3; p. 147
Main Authors:	Ricardo Ramirez, C, Álvarez Gómez, M L, Agudelo Vélez, C A, Zuluaga Penagos, S, Consuegra Peña, R A, Uribe Hernández, K, Mejía Gil, I C, Cano Londoño, E M, Elorza Parra, M, Franco Vásquez, J G
Format:	Journal Article
Language:	English Spanish
Published:	Spain 01-04-2019
Subjects:	Adolescent Child Child, Preschool Cholinergic Antagonists - adverse effects Critical Care Cross-Sectional Studies Delirium - epidemiology Delirium - etiology Female Humans Intellectual Disability - complications Intensive Care Units, Pediatric - statistics & numerical data Liver Failure - complications Male Nervous System Diseases - complications Prevalence Psychotropic Drugs - adverse effects Respiration, Artificial - adverse effects Tachycardia - complications Delirium Respiración artificial Nervous system diseases Taquicardia Cholinergic antagonists Pediatric intensive care units Artificial respiration Psychotropic drugs Liver failure Tachycardia Intellectual disability Unidades de cuidados intensivos pediátricos Antagonistas colinérgicos Enfermedades del sistema nervioso Psicotrópicos Discapacidad intelectual Delirio Fallo hepático
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Summary:	To evaluate the clinical characteristics, prevalence and factors associated with delirium in critical patients from 5 to 14 years of age. An analytical, cross-sectional observational study was made. Delirium was assessed with the Pediatric-Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU) and motor classification was established with the Delirium Rating Scale Revised-98. A pediatric Intensive Care Unit. All those admitted over a one-year period were assessed during the first 24-72h, or when possible in deeply sedated patients. Patients in stupor or coma, with severe communication difficulty, subjected to deep sedation throughout admission, and those with denied consent. Twenty-nine of the 156 assessed patients suffered delirium (18.6%) and 55.2% were hypoactive. The neurocognitive alterations evaluated by the pCAM-ICU were similar in the three motor groups. Intellectual disability (OR=17.54; 95%CI: 3.23-95.19), mechanical ventilation (OR=18.80; 95%CI: 4.29-82.28), liver failure (OR=54.88; 95%CI: 4.27-705.33), neurological disease (OR=4.41; 95%CI: 1.23-15.83), anticholinergic drug use (OR=3.23; 95%CI: 1.02-10.26), different psychotropic agents (OR=4.88; 95%CI: 1.42-16.73) and tachycardia (OR=4.74; 95%CI: 1.21-18.51) were associated to delirium according to the logistic regression analysis. The frequency of delirium and hypoactivity was high. It is therefore necessary to routinely evaluate patients with standardized instruments. All patients presented with important neurocognitive alterations. Several factors related with the physiopathology of delirium were associated to the diagnosis; some of them are modifiable through the rationalization of medical care.
ISSN:	1578-6749
DOI:	10.1016/j.medin.2018.01.013