Incidence and Factors Associated with Delirium in Children in a Single Pediatric Intensive Care Unit in Brazil

• Published in: Journal of pediatric nursing Vol. 61; pp. e29 - e34
• Main Authors: Flores, Alexandra Elizabeth Reinoso, Oura, Karina Hidemi Ueno, Rocha, Patricia Kuerten, Belela-Anacleto, Aline Santa Cruz, Kusahara, Denise M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2021
• Subjects: Delirium; Pediatric intensive care units; Pediatric nursing; Risk factors; Delirium; Pediatric intensive care units; Risk factors; Pediatric nursing
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2021.04.008

To identify the incidence of delirium in a Pediatric Intensive Care Unit (PICU); to determine the factors associated with the occurrence of delirium and the agreement between two scales used for detection of pediatric delirium in critically ill children. Descriptive longitudinal study carried out in a PICU. The sample consisted of 65 critically ill children admitted to the PICU, with more than 24 h of hospitalization, excluding children with neurological or cognitive impairment, hearing and visual impairment, chronic encephalopathy and declining consent to participate in the study. Two scales were applied, the Cornell Assessment of Pediatric Delirium (CAPD) and the Sophia Observation Withdrawal Symptoms – Pediatric Delirium Scale (SOS_PD). Descriptive and inferential statistical analysis, with a 5% significance level was performed. Delirium was identified in 7.7% of children, with duration of the disorder of about 2 days. A very good agreement (Kappa = 1; p-value <0.001) between the two scales was identified. CAPD presented positive predictive value of 80.0%. There was a statistical association between the occurrence of delirium and age less than 2 years (p = 0.060); female gender (p = 0.057); use of mechanical pulmonary ventilation (p = 0.034); antiemetics (p = 0.002); anticholinergics (p = 0.044), and changes in serum sodium and potassium (p = 0.053). Demographic, clinical, and pharmacological conditions were associated with the occurrence of delirium. Routine monitoring is the first step to any delirium prevention strategies, so delirium screening by the bedside nurse must be valued through a commitment to education and training. •Delirium is common in critically ill children but is frequently under-diagnosed.•The early detection of pediatric delirium allows timely intervention.•Delirium routine monitoring is an essential first step to any management strategies.•Delirium screening by the bedside nurse is essential for the early detection of complications.