Our objective is to validate multiple diagnostic instruments, especially the pCAM-ICU. By comparing these instruments, we can develope an algoritm which can be used by nursing staff to diagnose the pediatric delirium as soon as possible so that…
ID
Source
Brief title
Condition
- Deliria (incl confusion)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary study parameters are: delirium yes or no with a positive result
after diagnostic testing.
Secondary outcome
During the use of the diagnostic instruments, a few 'points' will be collected
in order to test the cut-off value.
The current use of medication will be documented as well as the reason of
admission in order to examine the etiology in retrospect of pediatric delirium.
Background summary
The pediatric delirium hasn't been studied for a long time. The prevalence is 5
to 35 percent. Because the pediatric delirium, and the delirium in general,
results in a longer length of stay with higher mortality rates, it is
neccessary to diagnose the delirium as quickly as possible. Because of its
fluctuating course it is difficult to diagnose the delirium. A good diagnostic
instrument can make diagnosing the delirium easier, faster and more efficient.
In adultpsychiatry there are a few diagnostic instruments which are not
validated for children yet. For example the CAM-ICU has resently been adapted
for use in children by Wes Ely and collaegues. Before these diagnostic
instruments can be used in the PICU they have to be validated first.
Study objective
Our objective is to validate multiple diagnostic instruments, especially the
pCAM-ICU. By comparing these instruments, we can develope an algoritm which can
be used by nursing staff to diagnose the pediatric delirium as soon as possible
so that farmacotherapy can be started.
Study design
The different diagnostic instruments (PAED, comfort-score, DRS-88/DRS-98,
pCAM-ICU) will be used twice a day in critically ill children in the PICU which
are non-elective OR longer than 48 hours after an elective operation and in the
age of 5 to 17 years. Informed consent is necessary.
Also we will note the patients medications.
There are two research teams: the first team consists of a child psychiatrist
and a child neuropsychologist (the golden standard / the reference team) and
the second team consists of a senior medical student together with a senior
psychology student (the validating team). When the second team finds a
pediatric delirium by using the diagnostic instruments, the first team will
confirm or reject the diagnosis. When the diagnosis pediatric delirium has been
made, farmacotherapy will be started.
(When the child intensivists suspect a pediatric delirium they will contact the
child psychiatrist for consultation).
Study burden and risks
Eventhough our patientpopulation is critically ill, most of the diagnostic
instruments will be observational and only the comfort-score and pCAM-ICU could
be considered "invasive / psychological invasive". There will be a short
physical contact to measure the muscle tone and some questions will be asked
regarding statements or pictures. The CAM-ICU and Comfort-score are already in
used in adult intensive care unit's (ICU's), and we expect that the burden will
be minimal in children as well.
P. Debyelaan 25
6202 AZ Maastricht
NL
P. Debyelaan 25
6202 AZ Maastricht
NL
Listed location countries
Age
Inclusion criteria
All non-elective patients admitted to the PICU between the age of 5 and 17.
Exclusion criteria
1. Children less than five years of age
2. Children of at least five years of age, but with a level of cognition less than five years of age.
3. Non-Dutch speakers.
4. Children with visual or hearing impairments who are unable to be assessed using the pCAM-ICU.
5. All patients admitted to the PICU on a elective base.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL28525.068.09 |