Delirium during the first evaluation of children aged five to 14 years admitted to a paediatric critical care unit.

OBJECTIVES: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5-14 years. METHOD/DESIGN: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24-72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type. We report the characteristics of PCAM-ICU delirium (at least three of the required items scored positive) and of subthreshold score cases (two positive items). RESULTS: Of 77 admissions, 15 (19.5%) had delirium, and 11 (14.2%) were subthreshold. A total of 53.3% of delirium and 45.5% of subthreshold cases were hypoactive. The prevalence of delirium and subthreshold PCAM-ICU was 83.3% and 16.7% in mechanically ventilated children. The most frequent combination of PCAM-ICU alterations in subthreshold cases was acute onset-fluctuation with altered alertness. The main nursing diagnoses were related to reduced cellular respiration. CONCLUSIONS: Delirium is common in critically ill children. It is necessary to assess whether certain nursing diagnoses imply an increase in delirium. Longitudinal studies of subthreshold PCAM-ICU cases are needed to understand their importance better.

Enfermedades más frecuentes de los neonatos del programa familiacanguro de la Clínica Universitaria Bolivariana de la ciudad de Medellín en el periodo de junio a diciembre de 2009 / Most frequent diseases in newborns of the kangaroo program of Clínica Universitaria Bolivariana in Medellin from June to December 2009

Objetivo: identificar las enfermedades más frecuentes de los niños del programa familia canguro, así como los antecedentes sociodemográficos y ginecobstétricos de la madre y características relacionadas con el recién nacido. Metodología: se realizó un estudio cuantitativo descriptivo en una muestra no probabilística a conveniencia, en el que se revisaron 86 historias clínicas de niños que fueron atendidos en el programa familia canguro de junio a diciembre de 2009, con un peso menor de 2 500 gr y con menos de 37 semanas de edad gestacional. Resultados: el promedio de edad de las madres fue de 26 ± 6.6 años. Un 50.2% pertenecía al estrato 2; 44.4% tenía secundaria completa; 40.7% está conformado por primigestantes y al 54.3% se le practicó cesárea. El promedio del peso de los niños al nacer fue de 1 715 ± 490 gramos. La edad gestacional en promedio fue de 33 ± 7.8 semanas. El 8.1% de los niños presentó bronquiolitis, 7% ictericia, 7% reflujo gastroesofágico y un 66.3% no presentó morbilidad. Conclusiones: el estudio mostró una baja frecuencia de enfermedades en los neonatos del programa madre-canguro de la Clínica Universitaria Bolivariana.

Objective: to identify the most frequent diseases in children of the kangaroo family program, as well as the mother ́s sociodemographic and gynecobstetric background and characteristics related to the new born. Methods: a descriptive quantitative study was made in a convinient nonprobabilístic sample, in which 86 medical histories of children who attended the kangaroo family program from June to December 2009 were reviewed, with a weight less than 2500 grams and with less than 37 weeks of gestational age. Results: the average age of the mothers was 26 ± 6.6 years old. 50.2% belonged to a socioeconomic status 2; 44.4% had completed secondary school; 40.7% were primiparous and 54.3% underwent caesarean. The average weight of the newborns was 1 715 ± 490 gr. The average gestational age was 33 ± 7.8 weeks. 8.1% of the children presented bronchiolitis, 7% jaundice, 7% Gastroesophageal reflux and 66.3% did not present any morbidityConclusions: the study showed a low frequency of diseases in infants of the mother kangaroo program of the Bolivarian University Clinic