Non-pharmacological methods to prevent delirium in pediatric intensive care units: a systematic review

Abstract

Delirium is a syndrome of acute-onset cerebral dysfunction characterized by impaired attention, awareness, and consciousness. Considering the adverse consequences for children, prevention and effective management of delirium are important. This systematic review aimed to determine the effectiveness of non-pharmacological methods for preventing delirium in pediatric intensive care units. This systematic review was designed and reported according to the PRISMA guidelines. Ten databases, including Cochrane, Cinahl, Clinical Key, EBSCO, PubMed, Science Direct, Wiley, Scopus, Web of Science, and Google Scholar, were searched using the keywords ("pediatric" or "child" or "children") and ("delirium" or "confusion" or "disorientation") and "intensive care unit" and "non-pharmacologic". The database search identified 2,390 studies. Five studies met the inclusion criteria and were included in the systematic review. The designs of the included studies were randomized controlled trials and quasi-experimental studies. The interventions evaluated to prevent delirium in children aged 0-21 included nursing bundle, massage therapy, reading books, and listening to music. The delirium levels of the children were assessed using the Cornell delirium assessment tool, the state-trait anxiety inventory for children, and the Sophia observation withdrawal symptoms-pediatric delirium scale. Nursing bundles and massage in pediatric intensive care units effectively prevent delirium.