Table 1 Summary of studies included in the systematic review
Type | Author (year) | Design | Sample size | Age (year) | Intervention | Primary outcome | Secondary outcome | Result |
|---|---|---|---|---|---|---|---|---|
PD | Cloedt et al. (2022) [43] | Cohort study | 314 | Under 21 | PAD bundle | Rate of delirium detection, pain, PD, level of agitation, cumulative doses of analgesics and sedatives per day | N/A | Detection of PD increased from 4% to 31.9% (p < 0.001) |
PD | Garcia Guerra et al. (2021) [33] | RCT | 60 | 1M-16 | Music intervention | Patient’s sedation status | PD | No change in PD |
PD | Rohlik et al. (2021) [44] | QI | 780 | N/A | BED bundle education, feedback, and implementation | Delirium assessment documentation rate, impact of delirium education, perceived confidence of delirium management, perceived barrier of delirium management | N/A | Increased delirium assessment documentation, nursing confidence in delirium management, and lowered perceived assessment barriers (p < 0.05) |
PD | Silver and Traube (2019) [45] | QI | 15 | 2–12 | Delirium prevention toolkit and PICU journal | Family satisfaction | N/A | Increased satisfaction of parents and family |
PD | Kawai et al. (2019) [46] | QI | 8 | 1–10 | BED bundle and noise pollution reduction | Hourly dB readings, the impact of pediatric delirium bundle | N/A | Lowered noise pollution in PICU (p < 0.01) |
ED | Byun et al. (2018) [32] | RCT | 66 | 2–8 | Mother’s voice | Emergence delirium | Postoperative pain | PAED score decreased (p = 0.006) |
ED | Nakamura et al. (2018) [47] | RCT | 100 | 18M-8 | Unilateral right-side stimulation of HT7 acupuncture point | Emergence delirium | Incidence and severity of emergence delirium, PACU length of stay, postoperative pain | No change in EA incidence |
PD | Rohlik et al. (2018) [30] | RCT | 2073 | 5–17 | Delirium education | PD, delirium assessment documentation rate, barriers to delirium assessment | N/A | Increased PD assessment and documentation rate |
ED | Zhong et al. (2018) [31] | RCT | 69 | 3–6 | Pre-operative visit | EA | Parental separation scale, mask acceptance scale, Aldrete score (time to discharge) | Lowered EA and propofol administration (p < 0.05) |
PD | Simone et al. (2017) [48] | QI | 1875 | 0–24 | ICU bundle implementation | Screening compliance, delirium prevalence, staff delirium knowledge and attitudes | N/A | Effective for improving delirium screening, detection, and treatment |
ED | Song et al. (2017) [34] | RCT | 127 | 2–8 | Mother’s voice | EA | Awakening time, PACU length of stay | Lowered EA, awakening time, and PACU length of stay |
ED | Ohashi et al. (2016) [49] | RCT | 40 | 1–6 | The ultrasound-guided II/IH nerve block | ED | Postoperative pain | Not effective in lowering emergence delirium. Effective in lowered use of intra-operative sevoflurane |
ED | Bailey et al. (2015) [29] | RCT | 93 | 2–10 | Video-based PPIA preparation | Patient anxiety | Parental anxiety, child observational measures, emergence delirium, postoperative pain | No change in emergence delirium However, higher self-efficacy was observed in helping their children in the OR. (p = 0.03, odds ratio [95% confidence interval] = 1.69 [1.07–2.87]) |
ED | Hilly et al. (2015) [50] | Cohort study | 56 | 3–18 | Pre-operative preparation workshop | Patient anxiety, parental anxiety, postoperative maladaptive behavior | PACU morphine consumption, PACU length of stay, emergence delirium | Patient anxiety and postoperative maladaptive behavior score lowered (p = 0.015) No change in emergence delirium |
ED | Kim et al. (2015) [51] | RCT | 117 | 2–7 | Video distraction and parental presence | Patient anxiety, parental anxiety, postoperative pain, emergence delirium, post-hospitalization behavior questionnaire | N/A | No change in emergence delirium |
ED | Kain et al. (2007) [42] | RCT | 408 | 2–10 | ADVANCE intervention | Patient anxiety | Parental anxiety, emergence delirium, analgesic consumption, PACU length of stay | Lowered patient anxiety (p = 0.006) and emergence delirium after surgery (p = 0.038) in the recovery room (p = 0.016) |