Inova Children's Hospital, Falls Church, Virginia, USA.
Curr Opin Cardiol. 2020 Jan;35(1):70-75. doi: 10.1097/HCO.0000000000000690.
Pediatric delirium has recently been recognized to occur frequently in the pediatric general and cardiac ICU. The purpose of this review is to highlight recent data on the prevalence, prevention, and management of this condition.
Pediatric delirium occurs in the pediatric cardiac ICU (PCICU) in as many as 67% of patients. Validated screening tools are now available to assist clinicians in the diagnosis of this condition. Research has shown a growing relationship between benzodiazepines, mainstays in the realm of sedation, and delirium. The full spectrum of risk factors has yet to be clearly elucidated. After normalization of the ICU environment, antipsychotics are infrequently required for treatment. While pediatric delirium has been associated with increased length of stay and cost, long-term morbidities are unknown at this time.
Application of bundles to normalize the PCICU environment may lead to decreased incidence of pediatric delirium. Multiinstitutional studies are indicated to further delineate optimal bundles, stratify treatment strategies, and investigate long-term morbidity in pediatric delirium.
儿科谵妄最近被认为在儿科普通和心脏重症监护病房（PCICU）中频繁发生。本文的目的是强调该疾病的患病率、预防和管理的最新数据。
多达 67%的儿科心脏重症监护病房（PCICU）患儿出现儿科谵妄。现在有经过验证的筛查工具可帮助临床医生诊断这种疾病。研究表明，苯二氮䓬类药物（镇静治疗的主要药物）与谵妄之间的关系日益密切。但仍未明确所有的危险因素。在 ICU 环境正常化后，很少需要使用抗精神病药物进行治疗。虽然儿科谵妄与住院时间延长和费用增加有关，但目前尚不清楚其长期的发病率。
应用各种干预措施使 PCICU 环境正常化可能会降低儿科谵妄的发生率。需要进行多机构研究以进一步确定最佳的干预措施、分层治疗策略，并研究儿科谵妄的长期发病率。
