Infection Was Associated With Intensive Care Unit Pediatric Delirium in Children Younger Than 2 Years Old: A Single-Center Observational Study

Abstract

Objective: The primary objective of this study was to investigate the prevalence of intensive care unit (ICU) pediatric delirium in Shanghai, China. Secondary objectives were to determine the association of hypoxia and infection with ICU pediatric delirium, and the impact between different age. Design: Prospective single-center observational study. Setting: Two pediatric intensive care unit (PICU) within a tertiary-A general hospital. Patients: Patients age between 1 month to 7 years in PICU who stayed at least 1 day were included. Convenance sampling was used. Interventions: None. Measurements and Main Results: Pediatric patients (n=639) were screened twice a day for the prevalence of ICU pediatric delirium by Cornell Assessment of Pediatric Delirium, 300 (46.95%) of them had infection and 213 (33.33%) had hypoxia in PICU. Children who suffered hypoxia remained more than three times likely to be delirious during their hospitalization compared with children who were not hypoxia, after controlling other covariates, the odds of pediatric delirium for subjects with hypoxia was 3.26 times (95% CI, 1.98-5.38) the odds without hypoxia. Also, the odds of pediatric delirium for subjects with infection was 2.55 times (95% CI, 1.58-4.11) the odds without infection adjusting for other covariates. After subgrouping by age, the occurrence of ICU pediatric delirium with infection for children younger than two years old was 5.37 times (95% CI, 3.09-9.33) compared with patients who were never infection, while that for the children equal to or older than two years old was no statistically significant relationship. Conclusions: The prevalence of ICU pediatric delirium was 31.30%, while there is an independent association of infection and hypoxia with ICU pediatric delirium. Furthermore, children younger than two years old took more risks on pediatric delirium when they were infected in this study, while there was no relationship between infection and pediatric delirium who aged 2 years or older.

Risk factors of delirium in a paediatric intensive care unit: A prospective case series study

“…The PICU in this study was a multi-bed monitoring room where children were susceptible to light and noise pollution and parents could not visit, resulting in a lack of family participation. Ge et al 21 found that the prevalence of delirium in a hospital in Shanghai was 31.30%, which might be related to the different ages of the enrolled children and the different variables collected in the two studies. While a higher occurrence was reported in surgical patients, the prevalence of paediatric delirium in the paediatric cardiac ICU (PCICU) was as high as 67%, 6 which could be due to different types of diseases.…”

“…Although Ge et al 21 have reported the incidence of delirium and its influencing factors in a PICU in China, the study population only covered children aged from 1 month to 7 years old. We designed a prospective study and included children of all ages in an attempt to comprehensively determine the incidence of delirium and the risk factors of delirium in critically ill children in a Chinese tertiary PICU.…”