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Delirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit.
Alvarez, Rita V; Palmer, Claire; Czaja, Angela S; Peyton, Chris; Silver, Gabrielle; Traube, Chani; Mourani, Peter M; Kaufman, Jon.
Afiliação
  • Alvarez RV; Section of Critical Care, Department of Pediatrics, Medical College of Wisconsin, Wauwatosa, WI. Electronic address: ralvarez@mcw.edu.
  • Palmer C; Research Institute Biostatistics Core, Department of Pediatrics, University of Colorado, Aurora, CO.
  • Czaja AS; Section of Critical Care, Department of Pediatrics, University of Colorado, Aurora, CO.
  • Peyton C; Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, CO.
  • Silver G; Department of Child Psychiatry, Weill Cornell Medical College, New York, NY.
  • Traube C; Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, NY.
  • Mourani PM; Section of Critical Care, Department of Pediatrics, University of Colorado, Aurora, CO.
  • Kaufman J; Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, CO.
J Pediatr ; 195: 206-212, 2018 04.
Article em En | MEDLINE | ID: mdl-29395177
OBJECTIVE: To determine incidence, associated risk factors, and characteristics of delirium in a pediatric cardiac intensive care unit (CICU). Delirium is a frequent and serious complication in adults after cardiac surgery, but there is limited understanding of its impact in children with critical cardiac disease. STUDY DESIGN: Single-center prospective observational study of CICU patients ≤21 years old. All were screened for delirium using the Cornell Assessment for Pediatric Delirium each 12-hour shift. RESULTS: Ninety-nine patients were included. Incidence of delirium was 57%. Median time to development of delirium was 1 day (95% CI 0, 1 days). Children with delirium were younger (geometric mean age 4 vs 46 months; P < .001), had longer periods of mechanical ventilation (mean 35.9 vs 8.8 hours; P = .002) and had longer cardiopulmonary bypass times (geometric mean 126 vs 81 minutes; P = .001). Delirious patients had longer length of CICU stay than those without delirium (median 3 (IQR 2, 12.5) vs 1 (IQR1, 2) days; P < .0001). A multivariable generalized linear mixed model showed a significant association between delirium and younger age (OR 0.35 for each additional month, 95% CI 0.19, 0.64), need for mechanical ventilation (OR 4.1, 95% CI 1.7, 9.89), and receipt of benzodiazepines (OR 3.78, 95% CI 1.46, 9.79). CONCLUSIONS: Delirium is common in patients in the pediatric CICU and is associated with longer length of stay. There may be opportunities for prevention of delirium by targeting modifiable risk factors, such as use of benzodiazepines.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Unidades de Terapia Intensiva Pediátrica / Unidades de Cuidados Coronarianos / Delírio / Cardiopatias Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Unidades de Terapia Intensiva Pediátrica / Unidades de Cuidados Coronarianos / Delírio / Cardiopatias Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos