Last update:
11-Mar-2026

Pediatric delirium is defined as an acute, complex, and fluctuating neuropsychiatric syndrome, characterized by attentional deficits and cognitive dysfunction, and frequently occurring in critically ill children admitted to Pediatric Intensive Care Units (PICUs). Delayed identification and intervention are associated with long-term morbidity, including persistent cognitive deficits and diminished post-hospitalization quality of life. Despite its deleterious effects, delirium remains underdiagnosed due to suboptimal screening. Predisposing (modifiable) and precipitating (nonmodifiable) risk factors have been associated with delirium development. Given the high associated morbidity, society guidelines and position statements have recently provided consensus recommendations for prompt identification of high risk children using validated, user-friendly screening tools for healthcare providers. Diagnosis is based on screening tools, with the most widely implemented, and the only validated tool available in Greek, adapted by our research team, is the Cornell Assessment of Pediatric Delirium (CAPD). Key challenges in delirium assessment include infants under two years of age, neonates, and children with psychomotor delay due to developmental issues. The prevention and management of pediatric delirium initially rely on treating the underlying cause, which often leads to rapid resolution, while minimizing triggers or exacerbating factors. Non-pharmacological first-line therapeutic interventions, such as music therapy, maintaining circadian rhythms, and family visitation, are low cost, safe, and easy to implement. Pharmacologic agents are adjunctive, reserved for refractory cases. Optimal prevention and management of pediatric delirium necessitate vigilant surveillance, prompt and accurate diagnosis, as well as an integrated care continuum spanning PICU course to post-discharge rehabilitation and functional recovery.

Key words: Cornell Assessment of Pediatric Delirium, Critical care, Critical disease, Delirium, Pediatrics.