{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:21:59Z","timestamp":1756902119883,"version":"3.44.0"},"reference-count":15,"publisher":"The Pediatric Pharmacy Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:sec>\n          <jats:title>Objective<\/jats:title>\n          <jats:p>Intensive care unit (ICU) delirium has been associated with increased length of hospital stay, morbidity, mechanical ventilation, and health care resource utilization. Antipsychotics are frequently used for ICU delirium management, despite a lack of robust evidence in the literature to support their benefit. Delirium screening may result in pharmacologic or non-pharmacologic treatment.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods<\/jats:title>\n          <jats:p>In January 2019 we began screening patients admitted to the pediatric ICU (PICU) for delirium using the Cornell Assessment for Pediatric Delirium (CAPD). We compared prescribing rates of antipsychotic medications before and after implementation. We also assessed length of hospital and ICU stay prior to initiating therapy, delirium score prior to initiation of therapy, time after initiation of therapy until score decreased to a level not suggestive of delirium, and continuation of antipsychotics outside of the PICU.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results<\/jats:title>\n          <jats:p>We did not observe a difference in the rate of antipsychotics use. There was, however, an increase in variability between pre- and post-intervention rates of prescribing. Patients who received an antipsychotic medication were hospitalized for an average of 18 days and in the ICU for 14 days prior to the first dose of an antipsychotic agent. They had an average CAPD score of 16, and had an average of 4 scores above 8 prior to starting treatment.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusion<\/jats:title>\n          <jats:p>This study highlights the need for additional research to demonstrate the role of antipsychotic medications in managing delirium in the PICU.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-28.2.156","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T15:32:34Z","timestamp":1682523154000},"page":"156-160","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Delirium Screening Tool on Antipsychotic Medication Use in a Pediatric Intensive Care Unit"],"prefix":"10.5863","volume":"28","author":[{"given":"Helen","family":"Berhane","sequence":"first","affiliation":[{"name":"Department of Pharmacy (HB), University of California San Diego Medical Center, San Diego, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Moss","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (JM), Lucile Packard Children's Hospital Stanford, Palo Alto, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (EK), Stanford University School of Medicine, Stanford, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"year":"2013","series-title":"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: DSM-5","key":"i2331-348X-28-2-156-b1","unstructured":"American Psychiatric Association.\n\t\t\t\t\t\n          \n            Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: DSM-5\n          .\n\t\t\t\t\tAmerican Psychiatric Association;\n\t\t\t\t\t2013."},{"key":"i2331-348X-28-2-156-b2","series-title":"Textbook of Interdisciplinary Pediatric Palliative Care","first-page":"251","year":"2011","unstructured":"Wolfe\n              J\n            ,\n\t\t\t\t\t\tHindsP,\n\t\t\t\t\t\tSourkesB.\n          \n            Textbook of Interdisciplinary Pediatric Palliative Care\n          .\n\t\t\t\t\t1st ed.\n\t\t\t\t\tPhiladelphia, PA:\n\t\t\t\t\tElsevier\/Saunders;\n\t\t\t\t\t2011:251\u2013265."},{"issue":"5","key":"i2331-348X-28-2-156-b3","series-title":"Crit Care Med","first-page":"891","article-title":"Delirium and mortality in critically ill children: epidemiology and outcomes of pediatric delirium","volume":"45","year":"2017","unstructured":"Traube\n              C\n            ,\n\t\t\t\t\t\tSilverG,\n\t\t\t\t\t\tGerberLM,\n\t\t\t\t\t\n          .\n\t\t\t\t\tDelirium and mortality in critically ill children: epidemiology and outcomes of pediatric delirium.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2017;45(5):891\u2013898."},{"issue":"5","key":"i2331-348X-28-2-156-b4","series-title":"Pediatr Clin North Am","first-page":"1117","article-title":"Delirium in pediatric critical care","volume":"64","year":"2017","unstructured":"Patel\n              A\n            ,\n\t\t\t\t\t\tBellMJ,\n\t\t\t\t\t\tTraubeC.\n          Delirium in pediatric critical care.\n\t\t\t\t\tPediatr Clin North Am.\n\t\t\t\t\t2017;64(5):1117\u20131132."},{"issue":"2","key":"i2331-348X-28-2-156-b5","series-title":"Pediatr Crit Care Med,","first-page":"e74","article-title":"2022 Society of Critical Care Medicine clinical practice guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients with consideration of the ICU environment and early mobility","volume":"23","year":"2022","unstructured":"Smith\n              HA\n            ,\n\t\t\t\t\t\tBesunderJB,\n\t\t\t\t\t\tBettersKA,\n\t\t\t\t\t\n          .\n\t\t\t\t\t2022 Society of Critical Care Medicine clinical practice guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients with consideration of the ICU environment and early mobility.\n\t\t\t\t\tPediatr Crit Care Med,2022;23(2):e74\u2013e110."},{"issue":"3","key":"i2331-348X-28-2-156-b6","series-title":"Crit Care Med","first-page":"656","article-title":"Cornell Assessment of Pediatric Delirium: a valid, rapid, observational tool for screening delirium in the PICU","volume":"42","year":"2014","unstructured":"Traube\n              C\n            ,\n\t\t\t\t\t\tSilverG,\n\t\t\t\t\t\tKearneyJ,\n\t\t\t\t\t\n          .\n\t\t\t\t\tCornell Assessment of Pediatric Delirium: a valid, rapid, observational tool for screening delirium in the PICU.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2014;42(3):656\u2013663."},{"issue":"26","key":"i2331-348X-28-2-156-b7","series-title":"N Engl J Med","first-page":"2506","article-title":"Haloperidol and ziprasidone for treatment of delirium in critical illness","volume":"379","year":"2018","unstructured":"Girard\n              TD\n            ,\n\t\t\t\t\t\tExlineMC,\n\t\t\t\t\t\tCarsonSS,\n\t\t\t\t\t\n          .\n\t\t\t\t\tHaloperidol and ziprasidone for treatment of delirium in critical illness.\n\t\t\t\t\tN Engl J Med.\n\t\t\t\t\t2018;379(26):2506\u20132516."},{"issue":"2","key":"i2331-348X-28-2-156-b8","series-title":"J Child Adolesc Psychopharmacol","first-page":"126","article-title":"Atypical antipsychotic medications to control symptoms of delirium in children and adolescents","volume":"22","year":"2012","unstructured":"Turkel\n              SB\n            ,\n\t\t\t\t\t\tJacobsonJ,\n\t\t\t\t\t\tMunzigE,\n\t\t\t\t\t\tTavar\u00e9CJ.\n          Atypical antipsychotic medications to control symptoms of delirium in children and adolescents.\n\t\t\t\t\tJ Child Adolesc Psychopharmacol.\n\t\t\t\t\t2012;22(2):126\u2013130."},{"issue":"3","key":"i2331-348X-28-2-156-b9","series-title":"J Pediatr Pharmacol Ther","first-page":"204","article-title":"Antipsychotic treatment of delirium in critically ill children: a retrospective matched cohort study","volume":"24","year":"2019","unstructured":"Kishk\n              OA\n            ,\n\t\t\t\t\t\tSimoneS,\n\t\t\t\t\t\tLardieriAB,\n\t\t\t\t\t\n          .\n\t\t\t\t\tAntipsychotic treatment of delirium in critically ill children: a retrospective matched cohort study.\n\t\t\t\t\tJ Pediatr Pharmacol Ther.\n\t\t\t\t\t2019;24(3):204\u2013213."},{"issue":"3","key":"i2331-348X-28-2-156-b10","series-title":"Pediatrics","first-page":"e20151940","article-title":"Diagnosis and management of delirium in critically ill infants: case report and review","volume":"137","year":"2016","unstructured":"Brahmbhatt\n              K\n            ,\n\t\t\t\t\t\tWhitgobE.\n          Diagnosis and management of delirium in critically ill infants: case report and review.\n\t\t\t\t\tPediatrics.\n\t\t\t\t\t2016;137(3):e20151940."},{"issue":"9","key":"i2331-348X-28-2-156-b11","series-title":"Crit Care Med","first-page":"e825","article-title":"Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","year":"2018","unstructured":"Devlin\n              JW\n            ,\n\t\t\t\t\t\tSkrobikY,\n\t\t\t\t\t\tG\u00e9linasC,\n\t\t\t\t\t\n          .\n\t\t\t\t\tClinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2018;46(9):e825\u2013e873."},{"issue":"2","key":"i2331-348X-28-2-156-b12","series-title":"Crit Care Med","first-page":"428","article-title":"Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial","volume":"38","year":"2010","unstructured":"Girard\n              TD\n            ,\n\t\t\t\t\t\tPandharipandePP,\n\t\t\t\t\t\tCarsonSS,\n\t\t\t\t\t\n          .\n\t\t\t\t\tFeasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2010;38(2):428\u2013437."},{"issue":"7","key":"i2331-348X-28-2-156-b13","series-title":"Lancet Respir Med","first-page":"515","article-title":"Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial","volume":"1","year":"2013","unstructured":"Page\n              VJ\n            ,\n\t\t\t\t\t\tElyEW,\n\t\t\t\t\t\tGatesS,\n\t\t\t\t\t\n          .\n\t\t\t\t\tEffect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial.\n\t\t\t\t\tLancet Respir Med.\n\t\t\t\t\t2013;1(7):515\u2013523."},{"issue":"1","key":"i2331-348X-28-2-156-b14","series-title":"Pediatr Crit Care Med","first-page":"21","article-title":"Delirium in a tertiary PICU: risk factors and outcomes","volume":"21","year":"2020","unstructured":"Dervan\n              LA\n            ,\n\t\t\t\t\t\tDi GennaroJL,\n\t\t\t\t\t\tFarrisRWD,\n\t\t\t\t\t\tWatsonRS.\n          Delirium in a tertiary PICU: risk factors and outcomes.\n\t\t\t\t\tPediatr Crit Care Med.\n\t\t\t\t\t2020;21(1):21\u201332."},{"issue":"7","key":"i2331-348X-28-2-156-b15","series-title":"JAMA Pediatr","first-page":"671","article-title":"Relationship between the functional status scale and the pediatric overall performance category and pediatric cerebral performance category scales","volume":"168","year":"2014","unstructured":"Pollack\n              MM\n            ,\n\t\t\t\t\t\tHolubkovR,\n\t\t\t\t\t\tFunaiT,\n\t\t\t\t\t\n          .\n\t\t\t\t\tRelationship between the functional status scale and the pediatric overall performance category and pediatric cerebral performance category scales.\n\t\t\t\t\tJAMA Pediatr.\n\t\t\t\t\t2014;168(7):671\u2013676."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/2\/article-p156.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/2\/156\/3213237\/i2331-348x-28-2-156.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/2\/article-p156.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/2\/article-p156.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:48:05Z","timestamp":1747356485000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/2\/article-p156.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":15,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-28.2.156","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"type":"electronic","value":"2331-348X"},{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2023]]}}}