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Article

Association between Platelet Transfusion and Delirium in Critically Ill Children

1
Morgan Stanley Children’s Hospital, NewYork-Presbyterian Columbia University, New York, NY 10032, USA
2
Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Children 2023, 10(5), 825; https://doi.org/10.3390/children10050825
Submission received: 28 February 2023 / Revised: 25 April 2023 / Accepted: 26 April 2023 / Published: 1 May 2023

Abstract

Delirium is a frequent, serious, and preventable complication in critically ill children. Inflammation has been implicated as a mechanism for the development of delirium. Platelet transfusions may potentiate the body’s pro-inflammatory responses. We hypothesized that receipt of platelets would be associated with delirium development in a pediatric intensive care unit (PICU). We performed a single-center retrospective cohort analysis including children admitted to the PICU between 2014 and 2018 who were transfused platelets within the first 14 days of admission. Data obtained included severity of illness, level of respiratory support, exposure to medications and blood products, as well as daily cognitive status. To account for time-dependent confounding, a marginal structural model (MSM) was constructed to delineate the relationship between platelet transfusion and next-day delirium. MSM demonstrated a 75% increase in the development of next-day delirium after transfusion of platelets (aOR 1.75, 95% CI 1.03–2.97). For every 1 cc/kg of platelet transfused, odds of next-day delirium increased by 9% (odds ratio 1.09, 95% CI 1.03–1.51). We reported an independent association between platelet transfusion and next-day delirium/coma after accounting for time-dependent confounders, with a dose–response effect. Minimizing platelet transfusions as much as clinically feasible may decrease delirium risk in critically ill children.
Keywords: delirium; platelet transfusion; pediatric intensive care unit; inflammation; platelets delirium; platelet transfusion; pediatric intensive care unit; inflammation; platelets

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MDPI and ACS Style

Nelligan, M.; Nellis, M.E.; Mauer, E.A.; Gerber, L.M.; Traube, C. Association between Platelet Transfusion and Delirium in Critically Ill Children. Children 2023, 10, 825. https://doi.org/10.3390/children10050825

AMA Style

Nelligan M, Nellis ME, Mauer EA, Gerber LM, Traube C. Association between Platelet Transfusion and Delirium in Critically Ill Children. Children. 2023; 10(5):825. https://doi.org/10.3390/children10050825

Chicago/Turabian Style

Nelligan, Matthew, Marianne E. Nellis, Elizabeth A. Mauer, Linda M. Gerber, and Chani Traube. 2023. "Association between Platelet Transfusion and Delirium in Critically Ill Children" Children 10, no. 5: 825. https://doi.org/10.3390/children10050825

APA Style

Nelligan, M., Nellis, M. E., Mauer, E. A., Gerber, L. M., & Traube, C. (2023). Association between Platelet Transfusion and Delirium in Critically Ill Children. Children, 10(5), 825. https://doi.org/10.3390/children10050825

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