A significant proportion of critically ill children experience delirium, a form of brain dysfunction associated with adverse outcomes. In children, delirium manifests with disorientation, restlessness, and agitation (hyperactive) or with unresponsiveness and excessive drowsiness (hypoactive). Children who develop delirium stay in the hospital longer and do worse after discharge compared to age-matched peers, which results in increased healthcare costs. Delirium also affects families, who often suffer from acute distress and post-traumatic stress disorder. Currently, critical care providers use intermittent behavioral assessment tools to diagnose delirium; however, this approach is prone to errors and does not reliably identify the hypoactive subtype that is more common in critically ill children.
In the proposed research, we plan to enroll 60 critically ill children at risk for experiencing delirium. These children will undergo daily 30-minute non-invasive brain wave recordings to understand how brain regions connect and communicate before, during and after delirium. Delirium is a disease state characterized by abnormal behavioral response to stimuli. Therefore, we will study brainwaves in resting state and after stimulation to understand how brain connectivity patterns change with sounds. This research will be the first to describe the strength and spatial patterns of brain connectivity that precede, accompany, and follow clinical delirium in critically ill children. This research will allow us to identify how changes in brain connectivity can lead to delirium in critically ill children.
Through the identification of brainwave patterns that predict and detect delirium, this research aims to improve long-term outcomes in critically ill children. Success of this research will enable critical care providers to identify delirium quickly, deliver personalized interventions in a timely manner and provide precise neurological prognosis in critically ill children at high-risk of developing delirium. This will directly benefit critically ill children and their families.