Delirium is common in children in the pediatric intensive care unit (PICU) who have undergone cardiothoracic surgery, data indicate.
The acute brain dysfunction is associated with serious illness and poor outcomes in adults, especially those undergoing cardiac surgery; however it has not been previously studied in pediatric cardiothoracic patients.
In this study, Anita Patel, MD, of New York Presbyterian Hospital, and colleagues conducted a prospective chart review of pediatric patients who underwent cardiopulmonary bypass over a 6-month period. Children were screened for delirium using the Cornell Assessment of Pediatric Delirium (CAPD) once per 12-hour shift. Data including demographics, illness severity (Pediatric Index of Mortality-PIM2), and surgery complexity (Risk Adjustment for Congenital Heart Surgery Score-RACHS) was collected and analyzed using uni- and multivariate analyses.
In total, 104 patients were included in the study. Over half (57.7%) of study participants experienced acute delirium. Younger age, PIM2 score, and PICU stay length were found to positively correlate with delirium risk (P<0.05). Developmental delay was not associated with increased risk.
Much like adults, the authors concluded that cardiothoracic PICU patients are at a significantly increased risk of delirium, highlighting the need for a targeted delirium screening in this patient population.
Patel A, Biagas K, Clark E, Gerber L, Mauer E, Traube C. Abstract 0001. Prospective Assessment of Pediatric Delirium: Risk Factors and Outcomes in Pediatric Cardiac Surgery. Presented at: The Society of Critical Care Medicine 45th Critical Care Congress. February 19-24, 2016. Orlando, Fla.