Delirium in the Pediatric Cardiac Extracorporeal Membrane Oxygenation Patient Population: A Case Series.

OBJECTIVE

To determine the prevalence of delirium in children who require extracorporeal membrane oxygenation.

DESIGN

Prospective observational longitudinal cohort study.

SETTING

Urban academic cardiothoracic ICU.

PATIENTS

All consecutive admissions to the cardiothoracic ICU who required venoarterial extracorporeal membrane oxygenation support.

INTERVENTIONS

Daily delirium screening with the Cornell Assessment for Pediatric Delirium.

MEASUREMENTS AND MAIN RESULTS

Eight children required extracorporeal membrane oxygenation during the study period, with a median extracorporeal membrane oxygenation duration of 202 hours (interquartile range, 99-302). All eight children developed delirium during their cardiothoracic ICU stay. Seventy-two days on extracorporeal membrane oxygenation were included in the analysis. A majority of patient days on extracorporeal membrane oxygenation were spent in coma (65%). Delirium was diagnosed during 21% of extracorporeal membrane oxygenation days. Only 13% of extracorporeal membrane oxygenation days were categorized as delirium free and coma free. Delirium screening was successfully completed on 70/72 days on extracorporeal membrane oxygenation (97%).

CONCLUSIONS

In this cohort, delirium occurred in all children who required venoarterial extracorporeal membrane oxygenation. It is likely that this patient population has an extremely high risk for delirium and will benefit from routine screening in order to detect and treat delirium sooner. This has potential to improve both short- and long-term outcomes.