Delirium in a level IV NICU: Prevalence & modifiable risk factors.

ObjectiveWe aim to determine delirium prevalence in a Level IV NICU, identify demographic risk factors, controllable risk factors, and associated outcomes.Study DesignSelect NICU patients with at least one Cornell Assessment for Pediatric Delirium score, studied over 1 year period. Demographics and outcomes were compared in relation to delirium status. Medication exposure was analyzed prior to 40 weeks PMA and at significant CAPD score events.ResultPrevalence of delirium in the eligible study group was 64%. The delirium group had a lower median gestational age and birthweight, but higher median length of stay, and possible increased mortality rate. Exposure to benzodiazepines was strongly associated with the delirium group, though confounding may exist. Dexmedetomidine was not significantly associated with the delirium group.ConclusionsIt is possible that delirium is significantly prevalent and under-recognized among NICU patients, particularly those with lower gestational age and birthweight, and may be associated with poor outcomes. Benzodiazepine exposure may be significantly associated with neonatal delirium onset. Further investigation is needed in this area of study.