Delirium among pediatric patients admitted to open-heart surgery  intensive care unit: A cross-sectional study investigating a common challenge and concern, and its inciting factors

Mohammadreza  Mirzaaghayan; Sara  Memarian; Alireza  Abdshah; Mojgan  Ghavami; Ghazale  Roozbahani; Fatemeh  Naseri; Mohammad Sajjad  Jolani; Masood  Ghahvechi; Behdad  Gharib

doi:10.18502/cjn.v23i3.17545

Mohammadreza Mirzaaghayan Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Sara Memarian Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Alireza Abdshah School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mojgan Ghavami Cardiovascular Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Ghazale Roozbahani School of Nursing, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Naseri School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Sajjad Jolani School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Masood Ghahvechi Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Behdad Gharib Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/cjn.v23i3.17545

Keywords: Delirium; Pediatric Intensive Care Units; Mechanical Ventilation; Heart Surgery; Complications

Abstract

Background: Delirium is a common challenge in pediatric open heart surgery intensive care units (OH-ICU). It is believed that emergence of delirium can lead to extended hospitalization periods. Therefore, we decided to investigate the association between delirium and its inciting factors in OH-ICU.

Methods: This was a cross-sectional study on 92 pediatric patients admitted to OH-ICU of “Children’s Medical Center” in Tehran, Iran, for more than 48 hours. To screen for delirium, the Cornell Assessment of Pediatric Delirium (CAPD ≥ 9) was utilized. Demographics, length of stay, development of complications, delirium, and factors associated with delirium were recorded.

Results: We observed 34 (37%) cases of delirium in patients in OH-ICU. We had 51% male patients and 49% female ones, with a median age of 8 (0.2-144) months.

11.5 hours (2-405) and they stayed in the hospital for a median of 4 days (2-31). The most common cardiac abnormality was ventricular septal defect (18%), associated with tetralogy of Fallot (TOF) (10%). Most of the patients (71%) experienced no adverse events during their stay; however, among those who did, vomiting and post-operation chorea were the most prevalent. Among the patients in our study, age [adjusted odds ratio (AOR) = 0.91], weight (AOR = 1.34), and sex (AOR = 0.31 for boys vs. girls) were significantly associated with delirium.

Conclusion: We observed delirium in 37% of the patients. Development of delirium in patients admitted to pediatric intensive care unit (PICU) was associated with younger age, female sex, and higher weight.