Evaluation of Pediatric Delirium in Saudi Arabian PICUs: A Comprehensive Assessment of Awareness and Management

Pharmacy Practice

  • Amani S. Alrossies1Pharmacy Practice Department, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
  • Abdulaziz A. Alsoqati2Department of Pediatric Critical Care, King Fahad Medical City, Riyadh, Saudi Arabia.
  • Majed H. Nahari3Pharmaceutical Care Services, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
  • May S. Alanazi4College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
  • Farah Alanazi4College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
  • Mohammed Kanan5Department of Pharmacy, Rafha General Hospital, Northern Border Health Cluster, Rafha, Saudi Arabia.

Volume 23 Issue 3 Pages 1-12

DOI: 10.18549/PharmPract.2025.3.3229

Abstract

Background: Pediatric delirium, a neuropsychiatric disorder, affects up to 66% of critically ill children, disrupting cerebral functioning. Often misdiagnosed or confused with other conditions, delirium remains a challenge in pediatric care. Objectives: to evaluate the awareness, practices, and management strategies for pediatric delirium in Saudi Arabia among healthcare professionals working in pediatric intensive care units (PICUs). Method: A cross-sectional study assessed pediatric delirium awareness and management among physicians practicing in PICUs across various healthcare facilities in Saudi Arabia. The study spanned from December 2023 to February 2024 and included physicians with expertise in pediatric delirium. Utilizing a validated tool, data analysis was performed using SPSS version 24®. Statistical analyses included chi-square and Fisher exact tests for categorical variables with two groups and One-Way ANOVA for those with more than two groups. A p-value of less than 0.05 was deemed statistically significant. Results: Ninety-eight participants responded to the emailed questionnaire (response rate: 61.25%). Most were PICU consultants (53.1%) working in government hospitals (85.7%). Uncertainty prevailed regarding delirium prevalence in their units (53.1%), with hyperactive delirium being the most reported type (31.6%). Preventive measures included maintaining a regular sleep-wake cycle (85.7%), modifying contributing factors (75.5%), and optimizing sedation goals (75.5%). The primary assessment tool was the Cornell Assessment of Pediatric Delirium (CAP-D). Supportive treatment (60.2%), non-pharmacological interventions (58.2%), and benzodiazepines (41.8%) were common preventive measures. A statistically significant association was found between professional qualification and recognition of delirium-mistaken conditions (p-value=0.001). PICUs with at least one consultant (p-value=0.023) and a nurse-to-patient ratio of 1:1 (p-value= <0.001) had significantly higher awareness, while single-patient rooms showed greater awareness compared to multiple-patient occupancy settings (p-value= 0.009) among healthcare professionals. Conclusion: The study identified inadequate knowledge of delirium and assessment in PICUs, underscores the importance of enhancing consultants’ knowledge working in these units, and considers the side effects of pharmacological interventions. Modifiable factors and non-pharmacological management should be encouraged to achieve an optimal outcome of pediatric delirium.

Keywords

  • pediatric delirium
  • awareness
  • management
  • intensive care unit
  • healthcare professionals
  • Saudi Arabia
Pharmacy Practice

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