C-Reactive Protein and Procalcitonin Levels May Not Predict Delirium in Critically Ill Children.

OBJECTIVES: The objective of this study was to investigate the relationship between C-reactive protein and procalcitonin and the diagnosis of delirium in critically ill children. DESIGN: Retrospective cohort study. SETTING: Tertiary care urban academic PICU. PATIENTS: All PICU patients (ages 0-21 yr) admitted between January 1, 2015, and December 31, 2017, who had a C-reactive protein and/or procalcitonin level drawn within the first 14 days of their PICU stay. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Each patient was screened for delirium and/or coma bid using the Cornell Assessment of Pediatric Delirium. Patient information including demographics, delirium status, and laboratory values were extracted from the electronic medical record. Seven-hundred thirty-four patients were enrolled, with C-reactive protein and procalcitonin levels drawn in 664 and 587 patients, respectively. Thirty-seven percent of patients (n = 274) were delirious on at least one study day. In bivariate analysis, C-reactive protein was not related to either delirium or coma. Procalcitonin was highest on days with coma and lowest on days with delirium. There was no statistically significant relationship between inflammatory markers and any subtype of delirium. CONCLUSIONS: Despite evidence of inflammatory markers being predictive of delirium in adults, in this retrospective pediatric cohort, no association was found between C-reactive protein or procalcitonin levels and development of delirium.