Characteristics of Delirium in the Pediatric Intensive Care Unit Using the Dynamic Symptoms Model

Résumé 0

"Background: Delirium is considered a symptom of acute brain dysfunction occurring in the adult and pediatric population, which can be approached from the Dynamic Symptoms Model to have a complete view of its characteristics.Objective: To describe the prevalence and characteristics of delirium in preschool-aged patients in the pediatric intensive care unit using the Dynamic Symptoms Model.Methodology: Cohort study conducted in a pediatric intensive care unit in the city of Bogotá, Colombia. Patients between 6 months and 5 years were included. The sample size was 31 patients, and a literature review was conducted for understanding patient factors that are correlated with a higher rate of delirium. Delirium was diagnosed with the scale of evaluation of Preschool Confusion in Intensive Care (PsCAM-ICU) in Spanish version, which has a high specificity (94.8%), sensitivity (93.3%) and a reliability kappa statistic of 0.95.Results: Delirium occurred in 25.8% of patients. The characteristics of these patients with delirium were: 62.5% had a primary diagnosis of acute respiratory infection and 37.5% had respiratory failure; 62.5% presented hypoactive and 37.5% hyperactive; bronchopulmonary dysplasia and bronchiolitis were the most common pathological antecedents, 50% received benzodiazepines, 33.3% narcotics, and 16.6% analgesics. Delirious patients had longer PICU (10 vs. 7 days), and hospital length of stay (7.5 vs. 2.2 days).Conclusion: Presence of delirium in critically ill children is evidenced, whose characteristics are contained in the Dynamic Symptoms Model, therefore, from this perspective it is possible to identify it opportunely."