• Jochen Meyburg, Mona-Lisa Dill, Rebecca von Haken, Susanne Picardi, Jens Hendrik Westhoff, Gabrielle Silver, and Chani Traube.
• Department of General Pediatrics, University Children's Hospital, Heidelberg, Germany.
• Pediatr Crit Care Me. 2018 Oct 1; 19 (10): e514-e521.

ObjectivesTo determine and quantify risk factors for postoperative pediatric delirium.DesignSingle-center prospective cohort study.SettingTwenty-two bed PICU in a tertiary care academic medical center in Germany.PatientsAll children admitted after major elective surgery (n = 93; 0-17 yr).InterventionsAfter awakening, children were screened for delirium using the Cornell Assessment of Pediatric Delirium bid over a period of 5 days. Demographic and clinical data were collected from the initiation of general anesthesia.Measurements And Main ResultsA total of 61 patients (66%) were delirious. Younger children developed delirium more frequently, and the symptoms were more pronounced. The number of preceding operations did not influence the risk of delirium. Total IV anesthesia had a lower risk than inhalational anesthesia (p < 0.05). Duration of anesthesia was similar in all groups. Patients with delirium had a longer duration of mechanical ventilation in the PICU (p < 0.001). Significant differences in cumulative doses of various medications (e.g., sedatives, analgesics, and anticholinergics) were noted between groups; these differences were independent of disease severity. Invasive catheters and respiratory devices (p < 0.01) as well as infections (p < 0.001) increased risk of delirium.ConclusionsA high prevalence of delirium was noted in the PICU, and several perioperative risk factors were identified. Our data may be a base for development of strategies to prevent and treat postoperative delirium in children.

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