J Pediatr Intensive Care 2020; 09(04): 271-276
DOI: 10.1055/s-0040-1712144
Original Article

Exposure to Anticholinergic Medications in Pediatric Severe Sepsis and Feasibility of Delirium Screening

1  Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, United States
,
1  Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, United States
,
Robert C. Tasker
1  Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, United States
2  Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States
› Author Affiliations
Funding The authors acknowledge that an internal award from the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital has been used for this article.

Abstract

In sepsis, anticholinergic dysregulation may result in encephalopathy or delirium during severe illness, either as a result of central inflammation or because of exposure to medications with anticholinergic activity. In this retrospective study, we determined the magnitude of anticholinergic drug exposure in 75 children with severe sepsis. We found that exposure over the first 5 days was high—median (interquartile range) daily anticholinergic drug scale score 4 (2–5)—and associated with higher vasoactive scores and death. We conclude that anticholinergic drug exposure is significant in severe sepsis, which means it may be a modifiable factor that should be studied further.



Publication History

Received: 13 January 2020

Accepted: 17 April 2020

Publication Date:
01 June 2020 (online)

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