Incidence and factors associated with delirium in critically ill patients under 5 years old

Abstract

Purpose

To determine the incidence and factors related to the presence of Delirium in children under 5 years of age hospitalized in the pediatric intensive care unit (PICU).

Design and Methods

Prospective observational study, through a convenience sampling. Fifty-two patients hospitalized in the PICU between 6 months and 5 years of age were included. The Preschool Confusion Assessment Method for the intensive care units (PSCAM-ICU) instrument was applied in its Spanish version. A bivariate analysis was performed to identify possible related factors.

Results

The incidence of delirium in the pediatric population under 5 years of age was 71.1%, with mainly hypoactive typology. Those who presented the event were characterized because they were mainly female, with an average age of 31 months, with lower weight compared with those who did not have delirium. Possible risk factors for delirium were found to be longer stays in the PICU and mechanical ventilation, higher levels of carbon dioxide pressure, lower levels of oxygen pressure, having orotracheal intubation, and medication with sedatives and analgesics.

Practice Implications

The high incidence of delirium in the pediatric population is notorious, mainly for younger girls and lower-weight children. The factors that showed to be potential risk factors were like those found in the literature. These factors can be incorporated by the care staff in PICUs, to prevent or identify delirium promptly and thus mitigate its impact.