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Background: Delirium is increasingly recognized in the pediatric cardiac intensive care unit (CICU) with an incidence up to 67% and is associated with worse outcomes including increased mortality, prolonged hospitalization, and increased rates of intubation and mechanical circulatory support. The Cornell Assessment for Pediatric Delirium (CAPD) is the only validated tool for the diagnosis of delirium in the pediatric population. The CAPD may be limited in children with developmental disabilities as it does not account for baseline ability in scoring. Prior work has identified low specificity for the CAPD in children with developmental disabilities and those requiring mechanical ventilation. This may lead to overdiagnosis and possible ‘overtreatment’ with pharmacologic therapies for delirium. Study aims were to identify the incidence of patients who were diagnosed with delirium upon CICU admission and describe characteristics of this population including age, developmental status, and medical complexity. Methods: Retrospective single-center cohort study. All children admitted to the CICU between October 1, 2021 to December 31, 2022. Delirium was defined as a CAPD score >9. Results: In total, 683 patients were admitted with a median age of 10 months. Admission delirium screening was performed in 584 (85%) patients, 196 (33.3%) met the a priori definition of delirium. Younger patients were more likely to have a positive delirium screen on admit with a median age of 6 months compared to 17 months in those with a negative screen (p=0.00). There were no significant differences in the frequency of chromosome abnormality (p=0.17), duration of CICU (p=0.196) or hospital length of stay (p=0.09) in patients with or without a positive delirium screen. Conclusion: Infants were more likely to screen positive for delirium upon admission to the CICU. Further investigation is needed to explore factors associated with positive CICU admission delirium screen.


Critical Care | Pediatrics


Presented at the 8th World Congress of Pediatric Cardiology and Cardiac Surgery; Washington, DC; August 27th-Sept 1, 2023.

Delirium on Admission to the CICU