title: Recurrent delirium after surgery for congenital heart disease in an infant.
abstract: OBJECTIVE
  The objective of this article is to describe a case of recurrent delirium after cardiac surgery in an infant.
  
  
  METHODS
  Case report. The institutional review board at Children's Hospital Los Angeles waived the need for informed consent.
  
  
  METHODS
  Cardiothoracic intensive care unit in a freestanding children's hospital.
  
  
  METHODS
  A male infant with hypoplastic left heart syndrome who developed delirium on consecutive admissions to the cardiothoracic intensive care unit after cardiac surgery.
  
  
  METHODS
  Pharmacologic intervention using the atypical antipsychotic olanzapine.
  
  
  RESULTS
  The symptoms of delirium resolved with the initiation and continuation of olanzapine on both occasions.
  
  
  CONCLUSIONS
  Delirium is a common, but often unrecognized, diagnosis in the intensive care unit. Its early recognition and treatment may prevent unnecessary use of narcotics and benzodiazepines, decrease length of stay and may improve long-term neurocognitive function. This case report describes an infant who developed discrete, consecutive episodes of delirium following surgery for congenital heart disease. Both episodes were treated effectively with olanzapine.
authors.affiliation: Department of Pediatrics and Anesthesiology Critical Care Medicine, Children's Hospital, Los Angeles, CA, USA. kmadden@chla.usc.edu
authors.forename: Kevin
authors.initials: K
authors.lastname: Madden
authors.forename: Susan
authors.initials: S
authors.lastname: Turkel
authors.forename: Julienne
authors.initials: J
authors.lastname: Jacobson
authors.forename: David
authors.initials: D
authors.lastname: Epstein
authors.forename: David Y
authors.initials: DY
authors.lastname: Moromisato
mesh_terms: D003693:Delirium / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000503:physiopathology / Q000601:surgery*; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000188:drug therapy*; D012008:Recurrence