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Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool
Evaluación del delirium en niños ingresados en la Unidad de Cuidados Intensivos: Herramienta psCAM-UCI
Avaliação do delirium em crianças internadas na Unidade de Terapia Intensiva: ferramenta psCAM-UTI
DOI:
https://doi.org/10.15446/av.enferm.v38n2.78690Keywords:
Delirium, Child, Preschool, Critical Care, Pediatrics, Psychomotor Agitation, Nursing. (en)Delirium, Preescolar, Pediatría, Cuidados Críticos, Agitación Psicomotora, Enfermería. (es)
Delirium, Pré-escolar, Pediatria, Cuidados Críticos, Agitação Psicomotora, Enfermagem. (pt)
Introducción: el delirium se ha identificado como un factor de riesgo para la mortalidad de pacientes en estado crítico, lo que genera un mayor impacto social y económico, teniendo en cuenta que los pacientes requieren más días de ventilación mecánica y una estancia hospitalaria prolongada en la unidad de cuidados intensivos (UCI), lo que incrementa los costos médicos de su estadía.
Objetivo: describir la prevalencia y las características de los episodios de delirium en una muestra de niños de seis meses a cinco años en estado crítico.
Métodos: estudio de cohorte en una Unidad de Cuidados Intensivos Pediátricos (UCIP) en Bogotá (Colombia). Los participantes fueron evaluados por el método de evaluación de confusión preescolar para la UCI (psCAM-UCI) dentro de las 24 horas iniciales del período de hospitalización.
Resultados: una cuarta parte de los participantes (25,8 %) presentó algún tipo de delirium. Entre ellos, se observaron dos subtipos de delirium: el 62,5 % de los casos era hipoactivo y el 37,5 % hiperactivo. Además, el 75% (6) de los participantes delirantes eran hombres y el 25 % (2) mujeres. En 62,5 % de los pacientes el diagnóstico primario fue infección de las vías respiratorias, mientras que la insuficiencia respiratoria fue diagnosticada en el 37,5 % restante.
Conclusiones: la implementación de herramientas de monitoreo del delirium con niños en estado crítico proporciona una mejor comprensión de la presentación clínica de este fenómeno y los factores de riesgo asociados, con lo cual es posible contribuir al diseño de estrategias de intervención eficientes.
Introdução: o delirium foi identificado como um fator de risco para a mortalidade de pacientes graves, o que gera maior impacto social e econômico, visto que os pacientes necessitam de mais dias de ventilação mecânica e internação prolongada na unidade de terapia intensiva (UTI), o que aumenta os custos médicos para a sua estadia.
Objetivo: descrever a prevalência e as características dos episódios de delirium em uma amostra de crianças de 6 meses a 5 anos, gravemente doentes.
Métodos: estudo de coorte em uma Unidade de Terapia Intensiva Pediátrica (UTIP) em Bogotá (Colômbia). Os participantes foram avaliados pelo método de avaliação de confusão pré-escolar para a UTI (psCAM-UTI) dentro das primeiras 24 horas do período de internação.
Resultados: um quarto dos participantes (25,8%) apresentou algum tipo de delirium. Entre eles, dois subtipos de delirium foram observados: 62,5% dos casos eram hipoativos e 37,5% hiperativos. Além disso, 75% (6) dos participantes delirantes eram do sexo masculino e 25% (2) feminino. Em 62,5 % dos pacientes, o diagnóstico primário foi infecção das vias respiratórias, enquanto a insuficiência respiratória foi diagnosticada em 37,5 % restante.
Conclusões: a implementação de instrumentos de monitorização do delirium com crianças gravemente doentes permite uma melhor compreensão da apresentação clínica do fenômeno e dos fatores de risco associados, de forma a contribuir para o desenho de estratégias de intervenção eficazes.
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