3.1 Applying Knowledge of Pediatric Delirium to Infants Under 6 Months of Age: Assessing the Boundaries of Care

Abstract

The child psychiatry consult team may be asked to assess and help manage agitation of critically ill infants. Delirium prevalence rates in the pediatric intensive care unit (PICU) have been reported in over 50% in infants and toddlers, with close to two-thirds on mechanical ventilation (MV). Continuous sedation is used in 90% of pediatric patients on MV. The infant CNS is immature, increasing the risk for delirium and complicating assessment. Delirium is a syndrome that may result from abnormalities in neuroinflammatory cascade, brain oxidative metabolism, and neurotransmitters. Critically ill infants in the PICU often have cardiac or respiratory disorders requiring surgery, continuous sedation, and risk of infection.