Recurrent delirium after surgery for congenital heart disease in an infant

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Objective:The objective of this article is to describe a case of recurrent delirium after cardiac surgery in an infant.Design:Case report. The institutional review board at Children's Hospital Los Angeles waived the need for informed consent.Setting:Cardiothoracic intensive care unit in a freestanding children's hospital.Patient:A male infant with hypoplastic left heart syndrome who developed delirium on consecutive admissions to the cardiothoracic intensive care unit after cardiac surgery.Intervention:Pharmacologic intervention using the atypical antipsychotic olanzapine.Measurements and Main Results:The symptoms of delirium resolved with the initiation and continuation of olanzapine on both occasions.Conclusion:Delirium is a common, but often unrecognized, diagnosis in the intensive care unit. Its early recognition and treatment may prevent unnecessary use of narcotics and benzodiazepines, decrease length of stay and may improve long-term neurocognitive function. This case report describes an infant who developed discrete, consecutive episodes of delirium following surgery for congenital heart disease. Both episodes were treated effectively with olanzapine.

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