J Pediatr Intensive Care 2021; 10(04): 243-247
DOI: 10.1055/s-0040-1719045
Review Article

Acquired Brain Injury in the Pediatric Intensive Care Unit: Special Considerations for Delirium Protocols

1   Department of Pediatric Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States
2   Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
3   Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
4   Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States
5   Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
6   Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
7   Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Sarah W. Goldberg
8   Division of Pediatric Cardiology, Boston Children's Hospital, Boston, Massachusetts, United States
Stacy J. Suskauer
6   Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
7   Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
9   Kennedy Krieger Institute, Baltimore, Maryland, United States
› Author Affiliations
Funding None.


The goal of this article was to highlight the overlapping nature of symptoms of delirium and acquired brain injury (ABI) in children and similarities and differences in treatment, with a focus on literature supporting an adverse effect of antipsychotic medications on recovery from brain injury. An interdisciplinary approach to education regarding overlap between symptoms of delirium and ABI is important for pediatric intensive care settings, particularly at this time when standardized procedures for delirium screening and management are being increasingly employed. Development of treatment protocols specific to children with ABI that combine both nonpharmacologic and pharmacologic strategies will reduce the risk of reliance on treatment strategies that are less preferred and optimize care for this population.

Publication History

Received: 26 August 2020

Accepted: 30 September 2020

Article published online:
03 November 2020

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