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Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units

CONTEXT: If delirium is not diagnosed, it is unlikely that any effort will be made to reverse it. Given evidence for under-diagnosis, tools that aid recognition are required. OBJECTIVE: Relating three presentations of pediatric delirium (PD) to standard criteria and developing a diagnostic algorithm...

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Autores principales: Schieveld, Jan N. M., van der Valk, Judith A., Smeets, Inge, Berghmans, Eline, Wassenberg, Renske, Leroy, Piet L. M. N., Vos, Gijs D., van Os, Jim
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765651/
https://www.ncbi.nlm.nih.gov/pubmed/19771408
http://dx.doi.org/10.1007/s00134-009-1652-8
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author Schieveld, Jan N. M.
van der Valk, Judith A.
Smeets, Inge
Berghmans, Eline
Wassenberg, Renske
Leroy, Piet L. M. N.
Vos, Gijs D.
van Os, Jim
author_facet Schieveld, Jan N. M.
van der Valk, Judith A.
Smeets, Inge
Berghmans, Eline
Wassenberg, Renske
Leroy, Piet L. M. N.
Vos, Gijs D.
van Os, Jim
author_sort Schieveld, Jan N. M.
collection PubMed
description CONTEXT: If delirium is not diagnosed, it is unlikely that any effort will be made to reverse it. Given evidence for under-diagnosis, tools that aid recognition are required. OBJECTIVE: Relating three presentations of pediatric delirium (PD) to standard criteria and developing a diagnostic algorithm. RESULTS: Delirium-inducing factors, disturbance of consciousness and inattention are common in PICU patients: a pre-delirious state is present in most. An algorithm is introduced, containing (1) evaluation of the sedation-agitation level, (2) psychometric assessment of behavior and (3) opinion of the caregivers. DISCUSSION: It may be argued that the behavioral focus of the algorithm would benefit from the inclusion of neurocognitive measures. LIMITATIONS: No sufficiently validated diagnostic instrument covering the entire algorithm is available yet. CONCLUSION: This is the first proposal for a PD diagnostic algorithm. Given the high prevalence of pre-delirious states at the PICU, daily evaluation is mandatory. Future algorithmic refinement is urgently required.
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spelling pubmed-27656512009-10-23 Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units Schieveld, Jan N. M. van der Valk, Judith A. Smeets, Inge Berghmans, Eline Wassenberg, Renske Leroy, Piet L. M. N. Vos, Gijs D. van Os, Jim Intensive Care Med Review CONTEXT: If delirium is not diagnosed, it is unlikely that any effort will be made to reverse it. Given evidence for under-diagnosis, tools that aid recognition are required. OBJECTIVE: Relating three presentations of pediatric delirium (PD) to standard criteria and developing a diagnostic algorithm. RESULTS: Delirium-inducing factors, disturbance of consciousness and inattention are common in PICU patients: a pre-delirious state is present in most. An algorithm is introduced, containing (1) evaluation of the sedation-agitation level, (2) psychometric assessment of behavior and (3) opinion of the caregivers. DISCUSSION: It may be argued that the behavioral focus of the algorithm would benefit from the inclusion of neurocognitive measures. LIMITATIONS: No sufficiently validated diagnostic instrument covering the entire algorithm is available yet. CONCLUSION: This is the first proposal for a PD diagnostic algorithm. Given the high prevalence of pre-delirious states at the PICU, daily evaluation is mandatory. Future algorithmic refinement is urgently required. Springer-Verlag 2009-09-22 2009 /pmc/articles/PMC2765651/ /pubmed/19771408 http://dx.doi.org/10.1007/s00134-009-1652-8 Text en © The Author(s) 2009 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Review
Schieveld, Jan N. M.
van der Valk, Judith A.
Smeets, Inge
Berghmans, Eline
Wassenberg, Renske
Leroy, Piet L. M. N.
Vos, Gijs D.
van Os, Jim
Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
title Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
title_full Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
title_fullStr Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
title_full_unstemmed Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
title_short Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
title_sort diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765651/
https://www.ncbi.nlm.nih.gov/pubmed/19771408
http://dx.doi.org/10.1007/s00134-009-1652-8
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