<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2020-0026_s_006_w2aab3b7c18b1b6b1aab1c15b1Aa"><h3>Introduction</h3><p>Pediatric delirium is a significant problem when encounterd in an intensive care unit (ICU). The pathophysiology of pediatric delirium is complex and the etiology is typically multifactorial. Even though various risk factors associated with pediatric delirium in a pediatric ICU have been identified, there is still a paucity of literature associated with the condition, especially in extremely critically ill children, sedated and mechanically ventilated.</p></sec><sec id="j_jccm-2020-0026_s_107_w2aab3b7c18b1b6b1aab1c15b2Aa"><h3>Aim of the study</h3><p>To identify factors associated with delirium in mechanically ventilated children in an ICU.</p></sec><sec id="j_jccm-2020-0026_s_007_w2aab3b7c18b1b6b1aab1c15b3Aa"><h3>Material and Methods</h3><p>This is a single-center study conducted at a tertiary care pediatric ICU. Patients admitted to the pediatric ICU requiring sedation and mechanical ventilation for >48 hours were included. Cornell Assessment of Pediatric Delirium scale was used to screen patients with delirium. Baseline demographic and clinical factors as well as daily and cumulative doses of medications were compared between patients with and without delirium. Firth’s penalized maximum likelihood logistic regression was used on a priori set of variables to examine the association of potential factors with delirium. Two regression models were created to assess the effect of daily medication doses (Model 1) as well as cumulative medication doses (Model 2) of opioids and benzodiazepines.</p></sec><sec id="j_jccm-2020-0026_s_008_w2aab3b7c18b1b6b1aab1c15b4Aa"><h3>Results</h3><p>95 patient visits met the inclusion criteria. 19 patients (20%) were diagnosed with delirium. Older patients (>12 years) had higher odds of developing delirium. Every 1mg/kg/day increase in daily doses of opioids was associated with an increased risk of delirium (OR=1.977, p=0.017). Likewise, 1 mg/kg increase in the cumulative opioid dose was associated with a higher odds of developing delirium (OR=1.035, p=0.022). Duration of mechanical ventilation was associated with the development of delirium in Model 1 (p=0.007).</p></sec><sec id="j_jccm-2020-0026_s_009_w2aab3b7c18b1b6b1aab1c15b5Aa"><h3>Conclusions</h3><p>Age, daily and cumulative opioid dosage and the duration of mechanical ventilation are associated with the development of delirium in mechanically ventilated children.</p></sec></abstract>

IntroductionPediatric delirium is a significant problem when encounterd in an intensive care unit (ICU). The pathophysiology of pediatric delirium is complex and the etiology is typically multifactorial. Even though various risk factors associated with pediatric delirium in a pediatric ICU have been identified, there is still a paucity of literature associated with the condition, especially in extremely critically ill children, sedated and mechanically ventilated.Aim of the studyTo identify factors associated with delirium in mechanically ventilated children in an ICU.Material and MethodsThis is a single-center study conducted at a tertiary care pediatric ICU. Patients admitted to the pediatric ICU requiring sedation and mechanical ventilation for >48 hours were included. Cornell Assessment of Pediatric Delirium scale was used to screen patients with delirium. Baseline demographic and clinical factors as well as daily and cumulative doses of medications were compared between patients with and without delirium. Firth’s penalized maximum likelihood logistic regression was used on a priori set of variables to examine the association of potential factors with delirium. Two regression models were created to assess the effect of daily medication doses (Model 1) as well as cumulative medication doses (Model 2) of opioids and benzodiazepines.Results95 patient visits met the inclusion criteria. 19 patients (20%) were diagnosed with delirium. Older patients (>12 years) had higher odds of developing delirium. Every 1mg/kg/day increase in daily doses of opioids was associated with an increased risk of delirium (OR=1.977, p=0.017). Likewise, 1 mg/kg increase in the cumulative opioid dose was associated with a higher odds of developing delirium (OR=1.035, p=0.022). Duration of mechanical ventilation was associated with the development of delirium in Model 1 (p=0.007).ConclusionsAge, daily and cumulative opioid dosage and the duration of mechanical ventilation are associated with the development of delirium in mechanically ventilated children.

Opioid Use Is Associated with ICU Delirium in Mechanically Ventilated Children

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Opioid Use Is Associated with ICU Delirium in Mechanically Ventilated Children"}

IntroductionPediatric delirium is a significant problem when encounterd in an intensive care unit (ICU). The pathophysiology of pediatric delirium is complex...

Opioid Use Is Associated with ICU Delirium in Mechanically Ventilated Children

Article Category: Research article

Online veröffentlicht: 11. Aug. 2020

Seitenbereich: 167 - 174

Eingereicht: 02. Mai 2020

Akzeptiert: 27. Juni 2020

DOI: https://doi.org/10.2478/jccm-2020-0026

Schlüsselwörter
pediatric delirium, mechanically ventilated children, intensive care unit

© 2020 Neha Gupta, Allison Woolley, Saurabh Talathi, Ganisher Davlyatov, Candice Colston, Leslie Hayes, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Opioid Use Is Associated with ICU Delirium in Mechanically Ventilated Children

Article Category: Research article

Online veröffentlicht: 11. Aug. 2020

Seitenbereich: 167 - 174

Eingereicht: 02. Mai 2020

Akzeptiert: 27. Juni 2020

DOI: https://doi.org/10.2478/jccm-2020-0026

Schlüsselwörterpediatric delirium, mechanically ventilated children, intensive care unit

© 2020 Neha Gupta, Allison Woolley, Saurabh Talathi, Ganisher Davlyatov, Candice Colston, Leslie Hayes, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Schlüsselwörter
pediatric delirium, mechanically ventilated children, intensive care unit