Volume 16, Issue 2 (11-2026)
Clin Exc 2026, 16(2): 10-20 |
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Sameh F, Salehi Y, Khajeh M, Rad M. Factors Associated With Delirium in Mechanically Ventilated Pediatric Patients: Systematic Review. , Clin Exc. 2026; 16 (2) :10-20
URL: http://ce.mazums.ac.ir/article-1-975-en.html
URL: http://ce.mazums.ac.ir/article-1-975-en.html
Iranian Research Center of Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
Abstract: (20 Views)
Background and Objective: Delirium is a significant complication among critically ill children, particularly those undergoing mechanical ventilation, associated with adverse outcomes such as prolonged hospitalization and impaired recovery. This systematic review aimed to synthesize evidence on risk factors associated with delirium in mechanically ventilated children.
Methods: A systematic search was conducted across major databases up to December 2025. Studies were included if they were in English. Study quality was assessed using the JBI checklist, and data were extracted by two independent reviewers.
Results: Fourteen studies involving 7,360 children were analyzed. Delirium assessment tools included Cornell Assessment of Pediatric Delirium, Preschool Confusion Assessment Method for the Intensive Care Unit, and Sophia Observation Withdrawal Symptoms–Pediatric Delirium scale. Prevalence ranged from 7.7% to 83.8%. Since all children included in the reviewed studies were mechanically ventilated by definition of the eligibility criteria, the duration of mechanical ventilation — rather than its mere presence — was the most significant associated factor. Younger age, neurological disorders, developmental delays, disease severity, infections, hypoxia, and metabolic disturbances also increased delirium risk. Regarding therapeutic interventions, benzodiazepines were the most frequent independent predictor, with some studies reporting a dose-response relationship. Opioids, deep sedation, physical restraint, and longer hospital stays were also linked to delirium. Furthermore, delirium was associated with increased length of stay and, in some studies, mortality.
Conclusion: Delirium in mechanically ventilated children is a frequent, multifactorial phenomenon. Identifying modifiable risk factors and implementing preventive interventions can reduce its incidence and improve clinical outcomes.
Methods: A systematic search was conducted across major databases up to December 2025. Studies were included if they were in English. Study quality was assessed using the JBI checklist, and data were extracted by two independent reviewers.
Results: Fourteen studies involving 7,360 children were analyzed. Delirium assessment tools included Cornell Assessment of Pediatric Delirium, Preschool Confusion Assessment Method for the Intensive Care Unit, and Sophia Observation Withdrawal Symptoms–Pediatric Delirium scale. Prevalence ranged from 7.7% to 83.8%. Since all children included in the reviewed studies were mechanically ventilated by definition of the eligibility criteria, the duration of mechanical ventilation — rather than its mere presence — was the most significant associated factor. Younger age, neurological disorders, developmental delays, disease severity, infections, hypoxia, and metabolic disturbances also increased delirium risk. Regarding therapeutic interventions, benzodiazepines were the most frequent independent predictor, with some studies reporting a dose-response relationship. Opioids, deep sedation, physical restraint, and longer hospital stays were also linked to delirium. Furthermore, delirium was associated with increased length of stay and, in some studies, mortality.
Conclusion: Delirium in mechanically ventilated children is a frequent, multifactorial phenomenon. Identifying modifiable risk factors and implementing preventive interventions can reduce its incidence and improve clinical outcomes.
Keywords: Delirium, Mechanical ventilation, Pediatric intensive care unit, Pediatric, risk factors, Systematic review
Type of Study: Review |
Subject:
بیماریهای کودکان
Received: 2026/07/25 | Accepted: 2026/08/5 | Published: 2026/11/1
Received: 2026/07/25 | Accepted: 2026/08/5 | Published: 2026/11/1
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