Delirium in Children: Identification, Prevention, and Management

Abstract

Delirium in children is an often underrecognized but serious complication of hospitalization. Delirium in this age group has been described as behaviors such as refractory agitation and restlessness, visual or auditory hallucinations, children being "not themselves," and a lethargic state. Often, children with delirium are at risk for harming themselves by dislodging tubes, falling, or refusing care. Pediatric nurses must recognize and intervene to prevent and treat delirium in hospitalized children because the delirium may be an indicator of worsening clinical status and is associated with high mortality and morbidity in children of all ages and with posttraumatic stress disorder. Pediatric nurses are uniquely positioned to design care interventions to both reduce risk for delirium and treat active delirium. Many treatment recommendations are nonpharmacological and are part of excellent nursing care. (Critical Care Nurse. 2017; 37[3]:e9-e18)

A systematic review of the impact of intensive care admissions on post discharge cognition in children

“…It is interesting to note that the risk factors for cognitive impairment identified here parallel risk factors for pediatric delirium, particularly hospitalization duration, invasive interventions, use of pain medication and sedation, foreign environment and a lack of familial presence. [38][39][40] As such, delirium-prevention bundles could be effective in reducing cognitive impairment. [40][41][42] To conclude, this systematic review established that ICU hospitalization in and of itself has a significant negative impact on the cognitive status and development of survivors, both in the short and long term.…”

“…[38][39][40] As such, delirium-prevention bundles could be effective in reducing cognitive impairment. [40][41][42] To conclude, this systematic review established that ICU hospitalization in and of itself has a significant negative impact on the cognitive status and development of survivors, both in the short and long term. The results have significant consequences for future research and clinical practice.…”

Delirium-The Effect off Children Anesthesiology after Surgery

“…The frequency of the ED phenomenon can be significantly reduced given that there are identifiable presurgical risks, which should prompt the adoption of a common ED anesthetic technique. 10 ED is a common complication in anesthetized…”

Nursing Responsibilities and Roles in Delirium Management in Pediatric Intensive Care Unit

“…Ciddi beyin fonksiyon bozukluğu ile karakterize olan deliryum sıklıkla yoğun bakım ünitelerinde görüldüğü için "yoğun bakım psikozu" ya da "yoğun bakım sendromu" olarak da adlandırılmaktadır (3,4). Ruhsal Bozuklukların (5,6).…”

“…Bilişsel gerilemeye, kendi kendine ekstübasyona, hastanın hospitalizasyon ve mekanik ventilasyon desteği süresinin uzamasına, mortalite ve morbidite oranlarının artmasına neden olan deliryumun pediatrik popülasyonda görülme sıklığı %10-60 arasında değişmekte; özellikle entübe olan ve cerrahi operasyon geçirmiş çocuklarda %80'e kadar çıkabilmektedir (3)(4)(5). Pediatrik deliryum öncelik sırasına göre zaman, mekân ve kişi oryantasyonunun bozulmasına yol açmakla birlikte belirti ve bulgular deliryumun tipine göre de farklılık göstermektedir (7,8).…”