소아중환자실 입원 아동의 섬망 발생 관련 요인

PURPOSE: This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors. METHODS: The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, x(2) test, t-test, and logistic regression analyses. RESULTS: The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age (x(2)=14.10, p=.007), admission type (x(2)=7.40, p=.007), use of physical restraints (x(2)=26.11, p<.001), RASS score (x(2)=14.80, p=.001), need for oxygen (x(2)=5.31, p=.021), use of a mechanical device (x(2)=9.97, p=.041), feeding (x(2)=7.85, p=.005), and the presence of familiar objects (x(2)=29.21, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002). CONCLUSION: Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.