Delirium: An Emerging Frontier in the Management of Critically Ill Children

The objectives of this article are (1) to introduce pediatric delirium and provide understanding of acute brain dysfunction with its classification and clinical presentations (2) to understand how delirium is diagnosed and discuss current modes of delirium diagnosis in the critically ill adult population and translation to pediatrics (3) to understand the prevalence and prognostic significance of delirium in the adult and pediatric critically ill population (4) to discuss the pathophysiology of delirium as currently understood, and (5) to provide general management guidelines for delirium.

Keywords: Brain dysfunction, Confusion, Delirium, Encephalopathy, Pediatric, Critical care, Psychosis

a Pediatrics and Anesthesiology Division of Critical Care, Department of Pediatrics, 5121 Doctor's Office Tower, 2200 Children's Way, Nashville TN 37232-9075, USA

b Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

c Division of Critical Care, Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

d Division Chief, Critical Care, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

e Center for Health Services Research and Division of Allergy/Pulmonary/Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

Corresponding author.

This work was supported by National Institutes of Health (AG001023); Veterans Affairs Clinical Science Research and Development Service (VA Merit Review Award and Career Development Award), and the Veterans Affairs Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC).

PII: S0749-0704(09)00041-4

doi:10.1016/j.ccc.2009.05.002

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