• Sagar Patel, Brent Pfeiffer, Rosa Haddock De Jesus, Jennifer Garcia, Jayanthi Chandar, and Amanda Alladin.
• Pediatric Critical Care Fellowship Program, Department of Pediatrics, Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, FL.
• Pediatr Crit Care Me. 2024 Sep 1; 25 (9): 838847838-847.

ObjectivesTo describe and compare the results of delirium screening in the immediate post-transplant PICU admission for pediatric intestinal, liver, and renal transplant recipients. We also examined associations with known and suspected risk factors for pediatric delirium (PD).DesignRetrospective analysis of a single-center cohort, 2016-2022.SettingTwenty-four-bed PICU in a high-volume transplant center.PatientsAll intestinal, liver, and renal transplant recipients under 23 years old admitted between July 2016 and August 2022.Measurements And Main ResultsWe identified 211 pediatric transplant recipients: intestinal ( n = 36), liver ( n = 78), and renal ( n = 97). Results of the Cornell Assessment for PD during the immediate post-transplant PICU admission were reviewed and patients were categorized into screen positive, screen negative, and unscreened. Corresponding data on known and suspected risk factors for PD were also collected. Data on delirium subtypes were not collected. Screens were available for 156 of 211 patients (74%) who were included in the final analysis. The prevalence of a positive screen by transplant category was: intestine 80% (24/30), liver 75% (47/63), and renal 14% (9/63). A positive screen was associated with younger age, greater duration of mechanical ventilation, and greater PICU length of stay (LOS) in bivariate analysis. In multivariable analysis, age and PICU LOS remained strongly correlated with a positive screen ( p < 0.05). Deep sedation and agitation as categorized by the State Behavioral Scale was associated with a positive screen, as was significant iatrogenic withdrawal symptoms ( p < 0.05). Most patients screened positive by post-transplant days 2 and 3 (58/80 [72%] and 64/80 [80%], respectively).ConclusionsIn our 2016 to 2022 experience, we found a high prevalence of positive PD screens in pediatric intestinal and liver transplant recipients in the immediate post-transplant PICU admission. A positive screen was associated with younger age and greater PICU LOS.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

34 keywords...

hide…