Delirium in Critically Ill Adolescents

Delirium is a common manifestation of acute brain dysfunction in critically ill adolescents. Delirium has a fluctuating course and disturbs consciousness and cognition, occurring in about 17% of youth in intensive care unit. Three subtypes are: hyperactive, hypoactive and mixed. Many medical conditions may have a role as a precipitating or predisposing factor such as infections, trauma, severe renal, cardiac, respiratory or metabolic diseases, poisoning,... . Independent risk factors for delirium are important such as mechanical ventilation, sedative drugs especially Benzodiazepines and anticholinergic and ICU environment itself (because of noises, lights, cold environment, catheters).Because delirium is a dangerous and fatal condition, timely intervention is absolutely important. At first, addressing any underlying causes or triggers, then, supportive care for preventing complications are important. Delirious patient must be repeatedly reoriented about time, place and persons. Treating pain, avoiding use of physicalrestraints, avoiding changes in surroundings and caregivers when possible, involving family members are considered. Circadian rhythm of sleep-wake must be restored.The most prescribed medications for controlling delirium are Haloperidol and Risperidone.