Delirium in critically ill children

Abstract

Delirium in critically ill patients is a medical condition that affects adults and children alike and has serious consequences for both populations, including prolonged hospital stay, high risk of death, long-term cognitive impairment, as well as increased health care costs. In the pediatric population, the main complication of this condition lies in its difficult recognition given that it can occur at very early ages, even in infants, when its signs and symptoms can be confused or overlapped with other pathologies such as withdrawal syndrome. Consequently, diagnostic tools may be more difficult to implement and use in these cases. Studies on delirium in children were scarce until 2011, when the first scale designed specifically for monitoring patients in pediatric intensive care units was developed. Thanks to this scale, the number of delirium cases in critically ill children under 5 years of age significantly increased, which in turn, made pediatricians to be more interested in studying this important pathology. This reflection paper, based on a literature review, seeks to update the broad physiopathological spectrum of delirium in critically ill children and thus improve their screening, diagnosis and early treatment in all pediatric age groups, even in patients under 5 years of age.