Risk Factors for the Development of Postoperative Delirium in Pediatric Intensive Care Patients.
Pediatr Crit Care Med
; 19(10): e514-e521, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-30059477
ABSTRACT
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 MAINRESULTS:
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Delírio do Despertar
/
Anestesia por Inalação
/
Anestesia Intravenosa
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
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Child, preschool
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Female
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Humans
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Infant
/
Male
Idioma:
En
Revista:
Pediatr Crit Care Med
Assunto da revista:
PEDIATRIA
/
TERAPIA INTENSIVA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha