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Delirium in Children after Cardiac Bypass Surgery
Open accessAbstract
OBJECTIVES: To describe the incidence of delirium in pediatric patients after cardiac bypass surgery and explore associated risk factors and effect of delirium on in-hospital outcomes. DESIGN: Prospective observational single-center study. SETTING: Fourteen-bed pediatric cardiothoracic ICU. PATIENTS: One hundred ninety-four consecutive admissions following cardiac bypass surgery, 1 day to 21 years old. INTERVENTIONS: Subjects were screened for delirium daily using the Cornell Assessment of Pediatric Delirium. MEASUREMENTS AND MAIN RESULTS: Incidence of delirium in this sample was 49%. Delirium most often lasted 1-2 days and developed within the first 1-3 days after surgery. Age less than 2 years, developmental delay, higher Risk Adjustment for Congenital Heart Surgery 1 score, cyanotic disease, and albumin less than three were all independently associated with development of delirium in a multivariable model (all p < 0.03). Delirium was an independent predictor of prolonged ICU length of stay, with patients who were ever delirious having a 60% increase in ICU days compared with patients who were never delirious (p < 0.01). CONCLUSIONS: In our institution, delirium is a frequent problem in children after cardiac bypass surgery, with identifiable risk factors. Our study suggests that cardiac bypass surgery significantly increases children's susceptibility to delirium. This highlights the need for heightened, targeted delirium screening in all pediatric cardiothoracic ICUs to potentially improve outcomes in this vulnerable patient population.
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“Given that delirium pathophysiology is directly linked to the underlying medical condition, its prevalence is tightly related to the population under study, estimated to be as high as 49% to 57% in children with cyanotic disease, longer durations of mechanical ventilation, and long cardiopulmonary bypass times [67,68].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [68]
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Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit
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Cognitive Trajectories after Postoperative Delirium
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Smith, H. A. B., Besunder, J. B., Betters, K. A., Johnson, P. N., Srinivasan, V., Stormorken, A., Farrington, E., Golianu, B. J., Godshall, A. J., Acinelli, L., et al. (2022) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000002873 · Cited by 537
Self-citationBenzodiazepines and Development of Delirium in Critically Ill Children: Estimating the Causal Effect
Mody, K., Kaur, S., Mauer, E. A., Gerber, L. M., Greenwald, B. M., Silver, G., & Traube, C. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003194 · Cited by 161
Self-citationDelirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit
Alvarez, R. V., Palmer, C., Czaja, A. S., Peyton, C., Silver, G., Traube, C., Mourani, P. M., & Kaufman, J. (2018) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.11.064 · Cited by 147
Self-citationDelirium in Pediatric Critical Care
Patel, A. K., Bell, M. J., & Traube, C. (2017) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2017.06.009 · Cited by 122
Self-citationA Systematic Review and Pooled Prevalence of Delirium in Critically Ill Children*
Semple, D., Howlett, M. M., Strawbridge, J. D., Breatnach, C. V., & Hayden, J. C. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005260 · Cited by 110
Metadata
- Authors
- Patel, A. K., Biagas, K. V., Clarke, E. C., Gerber, L. M., Mauer, E., Silver, G., Chai, P., Corda, R., & Traube, C.
- Affiliations
- NewYork–Presbyterian Hospital (US)
- Columbia University Irving Medical Center (US)
- Weill Cornell Medicine (US)
- Columbia University (US)
- ORCID
- Venue
- Pediatric Critical Care Medicine
- Published
- 2017-02
- Volume
- 18
- Issue
- 2
- Pages
- 165-171
- ISSN
- 1529-7535 (ISSN-L)
- PMC
- PMC5658045
- OpenAlex
- W2562671849
- Cited by
- 164
- References
- 25
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 28 · 2023: 19 · 2022: 16 · 2021: 22 · 2020: 16 · 2019: 14 · 2018: 12 · 2017: 8
- FWCI
- 10.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pediatric Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000457)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- delirium, pediatric cardiac surgery, cardiac bypass surgery, risk factors, incidence, ICU length of stay, developmental delay, cyanotic congenital heart disease, albumin, Cornell Assessment of Pediatric Delirium, delirium screening
- MeSH terms
- Adolescent, Cardiopulmonary Bypass, Child, Child, Preschool, Delirium, Female, Humans, Infant, Infant, Newborn, Length of Stay, Male, Postoperative Complications, Prognosis, Prospective Studies, Respiration, Artificial, Risk Factors, Intensive Care Units, Pediatric, Incidence, Logistic Models
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