A Wake-Up Call for the Pediatric Critical Care Community / by Alawi Luetz

Sapna R. Kudchadkar, a pediatric anesthesiologist and intensivist at Johns Hopkins University School of Medicine, published the results of the first international survey, investigating actual practice regarding sedation, delirium and sleep promotion management in critically ill children. Three-hundred and fourty-one respondents were inincluded in data analysis. North America was the continent with the largest proportion of respondents (70%), followed by Europe (14%) and Asia (9%).

Most respondents worked in PICUs with sedation scoring systems (70%), although only 42% of those with access to scoring systems reported routine daily use for goal-directed sedation management. Use of earplugs, eye masks, noise reduction, and lighting optimization for sleep promotion was uncommon. Delirium screening was not practiced in 71% of respondent’s PICUs, and only 2% reported routine screening at least twice a day.

The first analysis of our DIPI-ICU data revealed a delirium incidence of 23%. Even though data on delirium in children are still limited, there is preliminary evidence for significantly worse outcome in children with delirium compared to children without delirium. 

The recent survey provides a wealth of information on current practice and determinants of practice in PICUs, and indicates a demand for future research and educational interventions in this field.

Read the review on the ESICM webpage.