Risk factors for the development of postoperative delirium in pediatric intensive care patients

OBJECTIVES: To determine and quantify risk factors for postoperative pediatric delirium. - DESIGN: Single-center prospective cohort study. - SETTING: Twenty-two bed PICU in a tertiary care academic medical center in Germany. - PATIENTS: All children admitted after major elective surgery (n = 93; 0-1...

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Hauptverfasser: Meyburg, Jochen (VerfasserIn) , Ritsert, Mona-Lisa (VerfasserIn) , Haken, Rebecca von (VerfasserIn) , Picardi, Susanne (VerfasserIn) , Westhoff, Jens (VerfasserIn) , Silver, Gabrielle (VerfasserIn) , Traube, Chani (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2018
In: Pediatric critical care medicine
Year: 2018, Jahrgang: 19, Heft: 10, Pages: e514-e521
ISSN:1947-3893
DOI:10.1097/PCC.0000000000001681
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/PCC.0000000000001681
Volltext
Verfasserangaben:Jochen Meyburg, Mona-Lisa Dill, Rebecca von Haken, Susanne Picardi, Jens Hendrik Westhoff, Gabrielle Silver, Chani Traube

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520 |a OBJECTIVES: To determine and quantify risk factors for postoperative pediatric delirium. - DESIGN: Single-center prospective cohort study. - SETTING: Twenty-two bed PICU in a tertiary care academic medical center in Germany. - PATIENTS: All children admitted after major elective surgery (n = 93; 0-17 yr). - INTERVENTIONS: After awakening, children were screened for delirium using the Cornell Assessment of Pediatric Delirium bid over a period of 5 days. Demographic and clinical data were collected from the initiation of general anesthesia. - MEASUREMENTS AND MAIN RESULTS: A total of 61 patients (66%) were delirious. Younger children developed delirium more frequently, and the symptoms were more pronounced. The number of preceding operations did not influence the risk of delirium. Total IV anesthesia had a lower risk than inhalational anesthesia (p < 0.05). Duration of anesthesia was similar in all groups. Patients with delirium had a longer duration of mechanical ventilation in the PICU (p < 0.001). Significant differences in cumulative doses of various medications (e.g., sedatives, analgesics, and anticholinergics) were noted between groups; these differences were independent of disease severity. Invasive catheters and respiratory devices (p < 0.01) as well as infections (p < 0.001) increased risk of delirium. - CONCLUSIONS: A high prevalence of delirium was noted in the PICU, and several perioperative risk factors were identified. Our data may be a base for development of strategies to prevent and treat postoperative delirium in children. 
650 4 |a Age Factors 
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650 4 |a Anesthesia, Intravenous 
650 4 |a Case-Control Studies 
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650 4 |a Child, Preschool 
650 4 |a Dose-Response Relationship, Drug 
650 4 |a Emergence Delirium 
650 4 |a Female 
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650 4 |a Intensive Care Units, Pediatric 
650 4 |a Male 
650 4 |a Prevalence 
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650 4 |a Risk Factors 
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