PGY2 Pediatric Pharmacy Resident Children's Hospital Colorado Aurora, Colorado, United States
Background: Delirium is a common neuropsychiatric condition that occurs in critically ill patients within an intensive care unit (ICU) that is associated with increased mortality, prolonged hospital stay, higher hospitalization costs, and long-term disability. Risk factors for developing delirium include age less than 2 years, developmental delay, invasive ventilation, severe illness, surgery, and exposure to pro-deliriogenic medications. There are several assessment tools available for use in pediatric patients, including the Cornell Assessment of Pediatric Delirium scoring tool (CAPD) which is validated in patients ages 0-21 years of age. No medications have been approved to treat delirium, but antipsychotic medications such as risperidone may be used for delirium refractory to non-pharmacologic management strategies. However, there is a paucity of literature evaluating the safety and impact of risperidone on CAPD scores in young children, particularly in patients less than 1 year of age. Objective: The primary objective of this study is to evaluate the effects of risperidone on CAPD scores in infants less than 1 year of age with presumed or diagnosed delirium within a free-standing tertiary care pediatric hospital at specific time points. Secondary objectives include a descriptive review of risperidone use for patients less than 1 year of age, evaluation of the safety of risperidone use, and the effects of risperidone on concomitant sedatives and analgesics. Design/Methods: This retrospective single-center study has been approved by the local Institutional Review Board. Patients will be included if they are less than 1 year of age and have received risperidone for delirium management while admitted to any ICU within the institution between January 1, 2016, and June 30, 2023. Patients will be excluded if a CAPD score was not collected at baseline or within 48 hours of risperidone initiation or if risperidone was being used for an indication other than delirium. Descriptive analysis will be performed and finalized by January 2024.
