title: A case of infant delirium in the neonatal intensive care unit.
abstract: Infant delirium is an under-recognized clinical entity in neonatal intensive care, and earlier identification and treatment could minimize morbidities associated with this condition. We describe a case of a 6-month-old former 32 weeks gestation infant undergoing a prolonged mechanical ventilation course diagnosed with delirium related to the combination of his underlying illness and the use of multiple sedative and analgesic medications. Initiation of the atypical antipsychotic risperidone allowed for weaning from continuous infusions of benzodiazepines and opiods, and lower dosages of bolus-dosed sedation and analgesics. The patient experienced no adverse side effects from use of this neuroleptic.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Duke University Medical Center, Durham, NC, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Edwards
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: L B
authors.initials: LB
authors.lastname: Hutchison
authors.affiliation: Department of Pharmacy, Duke University Medical Center, Durham, NC, USA.
authors.forename: C D
authors.initials: CD
authors.lastname: Hornik
authors.affiliation: Department of Pediatrics, Division of Neonatology, Duke University Medical Center, Durham, NC, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Smith
authors.affiliation: Department of Pediatrics, Division of Neonatology, Duke University Medical Center, Durham, NC, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Cotten
authors.affiliation: Department of Pediatrics, Division of Neonatology, Duke University Medical Center, Durham, NC, USA.
authors.forename: M
authors.initials: M
authors.lastname: Bidegain
mesh_terms: D000588:Amines / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D006328:Cardiac Catheterization; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003693:Delirium / Q000209:etiology / Q000628:therapy*; D000069340:Deprescriptions; D020927:Dexmedetomidine / Q000009:adverse effects; D003975:Diazepam / Q000009:adverse effects; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D000077206:Gabapentin; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008691:Methadone / Q000009:adverse effects; D008874:Midazolam / Q000009:adverse effects; D010634:Phenobarbital / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000523:psychology*; D018967:Risperidone / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D003509:Cyclohexanecarboxylic Acids; D006993:Hypnotics and Sedatives; D005680:gamma-Aminobutyric Acid; D020927:Dexmedetomidine; D000077206:Gabapentin; D018967:Risperidone; D003975:Diazepam; D008874:Midazolam; D008691:Methadone; D005283:Fentanyl; D010634:Phenobarbital
keywords: Infant delirium; neonatal intensive care unit