Incidence and Factors Associated with Delirium in Children in a Single Pediatric Intensive Care Unit in Brazil.

Autor: Flores AER; Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil., Oura KHU; Pediatric Nursing Department, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil. Electronic address: karina.ueno@unifesp.br., Rocha PK; Departamento de Enfermagem, Universidade Federal de Santa Catarina, Brazil., Belela-Anacleto ASC; Pediatric Nursing Department, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil. Electronic address: aline.belela@unifesp.br., Kusahara DM; Pediatric Nursing Department, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, Brazil. Electronic address: dkusahara@unifesp.br.
Jazyk: angličtina
Zdroj: Journal of pediatric nursing [J Pediatr Nurs] 2021 Nov-Dec; Vol. 61, pp. e29-e34. Date of Electronic Publication: 2021 Apr 15.
DOI: 10.1016/j.pedn.2021.04.008
Abstrakt: Purpose: To identify the incidence of delirium in a Pediatric Intensive Care Unit (PICU); to determine the factors associated with the occurrence of delirium and the agreement between two scales used for detection of pediatric delirium in critically ill children.
Designs and Method: Descriptive longitudinal study carried out in a PICU. The sample consisted of 65 critically ill children admitted to the PICU, with more than 24 h of hospitalization, excluding children with neurological or cognitive impairment, hearing and visual impairment, chronic encephalopathy and declining consent to participate in the study. Two scales were applied, the Cornell Assessment of Pediatric Delirium (CAPD) and the Sophia Observation Withdrawal Symptoms - Pediatric Delirium Scale (SOS_PD). Descriptive and inferential statistical analysis, with a 5% significance level was performed.
Results: Delirium was identified in 7.7% of children, with duration of the disorder of about 2 days. A very good agreement (Kappa = 1; p-value <0.001) between the two scales was identified. CAPD presented positive predictive value of 80.0%. There was a statistical association between the occurrence of delirium and age less than 2 years (p = 0.060); female gender (p = 0.057); use of mechanical pulmonary ventilation (p = 0.034); antiemetics (p = 0.002); anticholinergics (p = 0.044), and changes in serum sodium and potassium (p = 0.053).
Conclusion: Demographic, clinical, and pharmacological conditions were associated with the occurrence of delirium.
Practice Implications: Routine monitoring is the first step to any delirium prevention strategies, so delirium screening by the bedside nurse must be valued through a commitment to education and training.
Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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