Division of Child and Adolescent Psychiatry, Department of Psychiatry and Psychology, European Graduate School of Neuroscience, SEARCH, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands.
Intensive Care Med. 2009 Nov;35(11):1843-9. doi: 10.1007/s00134-009-1652-8.
If delirium is not diagnosed, it is unlikely that any effort will be made to reverse it. Given evidence for under-diagnosis, tools that aid recognition are required.
Relating three presentations of pediatric delirium (PD) to standard criteria and developing a diagnostic algorithm.
Delirium-inducing factors, disturbance of consciousness and inattention are common in PICU patients: a pre-delirious state is present in most. An algorithm is introduced, containing (1) evaluation of the sedation-agitation level, (2) psychometric assessment of behavior and (3) opinion of the caregivers.
It may be argued that the behavioral focus of the algorithm would benefit from the inclusion of neurocognitive measures.
No sufficiently validated diagnostic instrument covering the entire algorithm is available yet.
This is the first proposal for a PD diagnostic algorithm. Given the high prevalence of predelirious states at the PICU, daily evaluation is mandatory. Future algorithmic refinement is urgently required.
如果未能诊断出谵妄，就不太可能会采取任何措施来逆转它。鉴于诊断不足的证据，需要使用有助于识别的工具。
将三种儿科谵妄（PD）表现与标准标准相关联，并制定诊断算法。
在 PICU 患者中，谵妄诱发因素、意识障碍和注意力不集中很常见：大多数患者都处于谵妄前状态。引入了一个算法，其中包含（1）镇静-躁动水平评估，（2）行为心理计量评估和（3）护理人员意见。
有人可能会认为，该算法的行为重点可以从包括神经认知措施中受益。
目前尚无涵盖整个算法的经过充分验证的诊断工具。
这是第一个 PD 诊断算法的建议。鉴于 PICU 中存在大量的谵妄前状态，必须进行日常评估。迫切需要进一步改进算法。
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