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

doi:10.1016/j.jpeds.2017.11.064

Cited by 111 publications

(136 citation statements)

References 62 publications

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“…The prevalence rates observed in this study are consistent with studies that have reported that, on average, 17.8% of PicU patients present delirium (3,9,(22)(23)(24). Finally, previous studies have shown an association between delirium and mortality of 5.24%.…”

Section: Discussionsupporting

confidence: 92%

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: Discussionsupporting

confidence: 92%

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

Castaño

Casas

2020

Av. enferm.

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“…Within published works, delirium has also become recognized as a biomarker of acute brain dysfunction . This devastating condition is associated with higher mortality, longer length of hospital stay, and prolonged mechanical ventilation time, making it a serious health‐care issue . Moreover, delirium is usually underrecognized in daily routine care; using assessment tools will improve the diagnostic accuracy of delirium .…”

Section: Introductionmentioning

confidence: 99%

Verifying the Japanese version of the Preschool Confusion Assessment Method for the ICU (psCAM‐ICU)

Matsuishi

Hoshino

Shimojo

et al. 2019

Acute Medicine & Surgery

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Aim Pediatric delirium has been well investigated and its prevalence is reported to be from 20% to 44%. For pediatric intensive care settings, several validated assessment tools for diagnosing delirium, including the Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM‐ICU), are available in English. However, validated assessment tools for identifying pediatric delirium are unavailable in Japanese. Therefore, the aim of this study is to verify the Japanese translation of the psCAM‐ICU. Methods We enrolled patients at the Pediatric ICU at University of Tsukuba Hospital (Tsukuba, Japan) from May 2017 to February 2019. Enrollment criteria included patients aged 6 months to 5 years, and we excluded coma patients scoring under −4 on the Richmond Agitation–Sedation Scale or suffering from stroke. Pediatric patient delirium was simultaneously evaluated by three medical workers (pediatric intensivist and researchers). Psychiatrists then verified these findings against criteria of the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition. We evaluated criterion validity (sensitivity and specificity) and reliability using Cohen's κ coefficient. Results We made a total of 56 independent assessments of 19 patients (42% female) with an average age of 18 (±15) weeks. Mechanical ventilation was used at least once in 73% of patients and the positive rate of delirium was 54% in total observation. Overall, the psCAM‐ICU showed high sensitivity, specificity (sensitivity, 0.90 [95% confidence interval [CI], 0.80–0.94]; specificity, 0.93 [95% CI, 0.83–0.97]), and high reliability within the researcher assessments (κ = 0.92; 95% CI, 0.82–1.0). Conclusion We verified the psCAM‐ICU and it shows high validity and reliability.

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“…Evaluation and treatment of delirium in critically ill children has garnered attention in the world of pediatrics . There are only a few international studies on PD and these studies suggest a prevalence rating from 25% to 66% . PD is associated with high morbidity and mortality and prolonged lengths of stay in intensive care .…”

Section: Introductionmentioning

confidence: 99%

The Cornell Assessment of Pediatric Delirium: Translation and inter‐rater reliability in a Danish pediatric intensive care unit

Simonsen

Lisby

Traube

et al. 2019

Acta Anaesthesiol Scand

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Background Delirium is a serious medical problem and recognized as a common syndrome in critically ill children. Without routine screening, delirium diagnosis is often missed by the medical providers. Internationally, there are tools to assess pediatric delirium (PD), but none currently available in Danish. The aim of this project was to translate the Cornell Assessment of Pediatric Delirium (CAPD) into Danish and determine its feasibility and reliability in a Danish clinical setting. Methods Translation was done in accordance with WHO guidelines. Linguistic and cultural differences were reconciled with the original developers of the instrument. The Danish CAPD was then tested in a prospective cohort of children admitted to a single pediatric intensive care unit at a university hospital in Denmark. Inter‐rater reliability was determined using weighted Kappa statistics. Results Thirty children were enrolled, and 92 delirium assessments were completed. Inter‐rater reliability (n = 84) revealed that inter‐observer agreement among the nurses was high (κ 0.85). The Danish version of the CAPD was successfully administered in all children. Conclusions Standardized assessment tools are a pre‐requisite to identify PD. A Danish version of the CAPD now exists, and preliminary testing has demonstrated it as feasible and reliable for use in a Danish clinical setting. A multi‐institutional study is needed to determine the prevalence of PD in Denmark.

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Delirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit

Cited by 111 publications

References 62 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

Verifying the Japanese version of the Preschool Confusion Assessment Method for the ICU (psCAM‐ICU)

The Cornell Assessment of Pediatric Delirium: Translation and inter‐rater reliability in a Danish pediatric intensive care unit

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