Pediatric Delirium: Evaluation, Management, and Special Considerations

Malas, Nasuh; Brahmbhatt, Khyati; McDermott, Cristin; Smith, Allanceson; Ortiz-Aguayo, Roberto; Turkel, Susan Beckwitt

doi:10.1007/s11920-017-0817-3

Cited by 54 publications

(45 citation statements)

References 96 publications

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“…Delirium is an altered state of consciousness characterized by fluctuating or acute changes in the mental state, lack of attention and the impossibility to receive, process, storage, and recover information (1,2). Among Intensive Care Units (icU), delirium in mechanically ventilated adults is between 60 and 80%, and between 20 and 60% in non-ventilated but critically ill patients (3).…”

Section: Introductionmentioning

confidence: 99%

Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool

Castaño

Casas

2020

Av. enferm.

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Background: Delirium has been identified as a risk factor for the mortality of critically ill patients, generating great social and economic impacts, since patients require more days of mechanical ventilation and a prolonged hospital stay in the intensive care unit (ICU), thus increasing medical costs. Objective: To describe the prevalence and characteristics of delirium episodes in a sample of 6-month to 5-year-old children who are critically ill. Methods: Cohort study at a Pediatric Intensive Care Unit (PICU) in Bogotá (Colombia). Participants were assessed by the Preschool Confusion Assessment Method for the ICU (psCAM-ICU) within the first twenty-four hours of hospitalization. Results: One quarter of the participants (25.8%) presented some type of delirium. Among them, two sub-types of delirium were observed: 62.5% of the cases were hypoactive and 37.5% hyperactive. Moreover, from them, six were male (75%) and 2 female (25%). Primary diagnosis was respiratory tract infection in 62.55% of the patients, while respiratory failure was diagnosed in the remaining 37.5%. Conclusions: The implementation of delirium monitoring tools in critically ill children provides a better understanding of the clinical manifestation of this phenomenon and associated risk factors in order to contribute to the design of efficient intervention strategies.

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Section: Introductionmentioning

confidence: 99%

Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool

Castaño

Casas

2020

Av. enferm.

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“…Delirium is a complex clinical syndrome in which underlying physical disease, pharmacologic factors or both cause acute onset of mental status change with fluctuating course, involving symptoms of inattention, altered level of awareness and other cognitive deficits 24. Management of delirium requires identification and treatment of underlying etiologies.…”

Section: Resultsmentioning

confidence: 99%

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry

Gerson

Malas

Feuer

et al. 2019

WestJEM

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Introduction Agitation in children and adolescents in the emergency department (ED) can be dangerous and distressing for patients, family and staff. We present consensus guidelines for management of agitation among pediatric patients in the ED, including non-pharmacologic methods and the use of immediate and as-needed medications. Methods Using the Delphi method of consensus, a workgroup comprised of 17 experts in emergency child and adolescent psychiatry and psychopharmacology from the the American Association for Emergency Psychiatry and the American Academy of Child and Adolescent Psychiatry Emergency Child Psychiatry Committee sought to create consensus guidelines for the management of acute agitation in children and adolescents in the ED. Results Consensus found that there should be a multimodal approach to managing agitation in the ED, and that etiology of agitation should drive choice of treatment. We describe general and specific recommendations for medication use. Conclusion These guidelines describing child and adolescent psychiatry expert consensus for the management of agitation in the ED may be of use to pediatricians and emergency physicians who are without immediate access to psychiatry consultation.

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“…2,[6][7][8][9] In adults, delirium is associated with long-term neurocognitive impairment; however, the long-term effect of delirium on children is still unknown. [10][11][12] Until recently, PD has been underrecognized. 13 A large body of literature in the last decade shed light on the prevalence and consequences of PD among critically ill children.…”

Section: Introductionmentioning

confidence: 99%

Practice Variability in Screening and Treating Pediatric Critical Illness Delirium: Survey

Aljabari

Carter

Waheed

et al. 2020

J Pediatr Intensive Care

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The best practice in pediatric delirium (PD) screening and treatment is still unknown. Current recommendations come from small studies and adult data. We surveyed the Pediatric Critical Care Medicine fellowship directors on PD screening and treatment practices in their centers. We report high variability in the screening and treatment practices for PD in large academic medical centers in the United States. The Cornell Assessment of Pediatric Delirium tool is the most commonly used tool for screening, and quetiapine is the most commonly used pharmacologic agent. A national guideline on PD screening, prevention, and treatment is needed to standardize practice and provide guidance.

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Pediatric Delirium: Evaluation, Management, and Special Considerations

Cited by 54 publications

References 96 publications

Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool

Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry

Practice Variability in Screening and Treating Pediatric Critical Illness Delirium: Survey

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