Investigation on status quo and subtypes of postoperative delirium in children with congenital heart disease / 中国实用护理杂志

ABSTRACT

Objective:To describe the status quo and subtypes of postoperative delirium (POD) in children with congenital heart disease in China.Methods:A total of 216 children with congenital heart disease who underwent surgery in Fuwai Hospital, Chinese Academy of Medical Sciences from December 2020 to June 2021 were prospectively observed. The status quo and subtypes of POD in children with congenital heart disease was evaluated according to the results of the Cornell assessment of pediatric delirium (CAPD).Results:POD occurred in 114 children (52.78%) during the study period. The onset time of POD was most on the first postoperative day (50.88%). POD lasted only 1 day in 54.39% of the children who developed it. The incidence of POD subtypes (hyperactive delirium, hypoactive delirium, mixed delirium) were 35.09%, 29.82% and 35.09%, respectively, and there was no significant difference in the incidence distribution among them ( χ2=0.63, P>0.05). The onset time of mixed delirium was significantly later than that of hyperactive delirium ( χ2=7.07, P<0.05), and the duration of mixed delirium was significantly longer than that of hypoactive delirium ( χ2=16.81, P<0.001). The results showed that if the child had blood transfusion during operation or the operation was difficult, the probability of reduced activity delirium after operation was higher ( P<0.016 7). Children wieth moderate to severe postoperative pain or short duration of muscle relaxant use during the evaluation period were more likely to have a hyperactive postoperative delirium.( P<0.016 7). The time of tracheal intubation, the time of hospitalization after operation and the the postoperative time in PICU were the longest in the children with mixed type of postoperative delirium ( P<0.016 7). Conclusions:POD has a high incidence in children with congenital heart disease, and it is more likely to occur in the early postoperative stage. Therefore, early postoperative identification and intervention of POD is of great significance for children with congenital heart disease. Children with different characteristics are prone to different types of POD, which should be paid attention to.