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5 岁以下危重症患儿发生谵妄的发生率及相关因素。

Incidence and factors associated with delirium in critically ill patients under 5 years old.

机构信息

Faculty of Nursing, Universidad Nacional de Colombia, Bogotá, Colombia.

出版信息

J Spec Pediatr Nurs. 2023 Jul;28(3):e12412. doi: 10.1111/jspn.12412. Epub 2023 Jun 23.

Abstract

PURPOSE

To determine the incidence and factors related to the presence of Delirium in children under 5 years of age hospitalized in the pediatric intensive care unit (PICU).

DESIGN AND METHODS

Prospective observational study, through a convenience sampling. Fifty-two patients hospitalized in the PICU between 6 months and 5 years of age were included. The Preschool Confusion Assessment Method for the intensive care units (PSCAM-ICU) instrument was applied in its Spanish version. A bivariate analysis was performed to identify possible related factors.

RESULTS

The incidence of delirium in the pediatric population under 5 years of age was 71.1%, with mainly hypoactive typology. Those who presented the event were characterized because they were mainly female, with an average age of 31 months, with lower weight compared with those who did not have delirium. Possible risk factors for delirium were found to be longer stays in the PICU and mechanical ventilation, higher levels of carbon dioxide pressure, lower levels of oxygen pressure, having orotracheal intubation, and medication with sedatives and analgesics.

PRACTICE IMPLICATIONS

The high incidence of delirium in the pediatric population is notorious, mainly for younger girls and lower-weight children. The factors that showed to be potential risk factors were like those found in the literature. These factors can be incorporated by the care staff in PICUs, to prevent or identify delirium promptly and thus mitigate its impact.

摘要

目的

确定在儿科重症监护病房(PICU)住院的 5 岁以下儿童发生谵妄的发生率及相关因素。

设计和方法

前瞻性观察性研究,采用便利抽样法。共纳入 52 名 6 个月至 5 岁在 PICU 住院的患儿。应用幼儿 ICU 意识模糊评估法(PSCAM-ICU)的西班牙语版本进行评估。进行了双变量分析以确定可能的相关因素。

结果

5 岁以下儿科人群的谵妄发生率为 71.1%,主要为低活动型。发生该事件的患儿主要为女性,平均年龄为 31 个月,与无谵妄的患儿相比,体重较低。谵妄的可能危险因素为在 PICU 停留时间和机械通气时间较长、二氧化碳压力较高、氧压力较低、经口气管插管和使用镇静和镇痛药物。

实践意义

儿科人群中谵妄的发生率很高,主要是年龄较小的女孩和体重较低的儿童。显示为潜在危险因素的因素与文献中发现的因素相似。这些因素可以被 PICU 的护理人员所吸收,以预防或迅速识别谵妄,并减轻其影响。

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