A bstract Background The number of studies evaluating delirium and its frequency in critically ill infants, children, and adolescents is increasing day by day. The primary objective of this study was to evaluate all patients hospitalized in our pediatric intensive care unit (PICU) in terms of pediatric delirium, to determine the frequency and risk factors of pediatric delirium. Patients and methods The patients included in this study had been hospitalized in the PICU between November 1, 2018, and August 31, 2019, and were followed up for more than 48 hours. Results Delirium was detected in 14 patients (9.9%) through regular evaluations. The Pediatric Index of Mortality 2 (PIM2) scores and the length of stay in the PICU were higher in patients with delirium ( p = 0.03 and p = 0.01, respectively). The use of respiratory support, sedation-analgesia, vasoactive and corticosteroid treatments, and physical restraints were higher in patients with delirium and were statistically significant ( p <0.05). Following admission to the PICU, psychosocial interventions were implemented for 76.1% of the whole cohort. Delirium developed in only five (4.5%) of the 108 patients who underwent psychosocial interventions, while it was detected in nine (26.5%) of the 34 patients who did not receive psychosocial interventions ( p = 0.001). The psychosocial intervention was associated with a lower likelihood of delirium (odds ratio [OR], 0.237; p = 0.044). An increasing number of days in the PICU was independently associated with increasing odds of delirium (OR, 1.095; p = 0.037 for each day). Conclusions We observed that the risk factors associated with delirium were similar to previous studies. Additionally, psychosocial intervention before delirium symptoms developed was associated with a lower risk of developing delirium. However, multicenter randomized controlled trials are needed on this subject. How to cite this article Yontem A, Yildizdas D, Horoz OO, et al. Frequency and Causes of Delirium in Pediatric Intensive Care Unit: A Prospective Observational Study. Indian J Crit Care Med 2021;25(6):715–719.

Aim: Patients in the PICU have high rates of mortality. In this study we researched whether platelet-lymphocyte ratio (PLR), in addition to other scoring methods, is an early predictor of mortality risk in PICU patients. Material and Method: The patient files of children hospitalized in the PICU between 2014 and 2015 were examined. Results: A total of 670 patients were included (46.9% girls and 53.1% boys). 25 (3.7%) of these children died. In patients who died, the GCS was below 9, and PRISM, PELOD, and PIM2 scores were above 12, 7, and 90, respectively (p<0.001 for each factor). Significant cut-off values were 2 (p<0.001) for lactate (100% sensitivity, 64.3% specificity) and 3.9 (p<0.001) for PLR (80% sensitivity, 68.9% specificity). Diagnoses such as hematological-oncological diseases, sepsis, or multi-organ failure in children admitted to the PICU were factors affecting mortality (p=0.001, p=0.008, and p<0.001, respectively). Other factors affecting mortality were found to be high PIM2 scores (p=0.041), hyperlactatemia (p<0.001), and high PLR (p<0.001). Discussion: In addition to known scoring methods, PLR is a beneficial predictive factor of mortality rate in PICU patients.

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Background: Assessment of intravascular volume status is important in pediatric patients admitted to the emergency departments and pediatric intensive care units. Inferior vena cava (IVC) diameter and collapsibility index are used to evaluate the intravascular volume status in adults. The normal range of IVC diameter is available for adults and the normal range considered for adults is between 1.7 to 2.1 cm, but such normative data is limited for children of all ages. Aims: Our aim in this study was to obtain the IVC and the aorta diameter reference values and the mean vena cava collapsibility index in healthy and normovolemic children. Subjects and Methods: Vena cava inferior and aorta images in B mode were obtained. IVC diameter in the inspiratory and the largest IVC diameter in the expiratory were recorded, and the vena cava collapsibility index was calculated. Results: Ultrasonographic measurements were performed in total on 1938 children. A significant positive correlation was found between IVC and aorta diameters with age. The collapsibility index was found as 37.2% (SD 11.8) in the overall study population. In addition, the reference values for the IVC and aorta diameters obtained from the measurements were also acquired. Conclusions: We believe that our IVC and aorta diameter measurements obtained from a large number of participants may be used as reference values in emergency departments and intensive care units.