Severe irritability in a critically ill preterm infant: a case of delirium at the neonatal intensive care unit

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMORAES, Lucas Hirano Arruda
dc.contributor.authorMAROPO, Vanessa Lisbethe Bezerra
dc.contributor.authorZOBOLI, Ivete
dc.contributor.authorFALCÃO, Mário Cícero
dc.contributor.authorCARVALHO, Werther Brunow de
dc.date.accessioned2023-05-08T14:57:08Z
dc.date.available2023-05-08T14:57:08Z
dc.date.issued2023
dc.description.abstractAbstract Delirium is a common disorder in intensive care units, being associated with greater morbidity and mortality. However, in neonatal intensive care units, delirium is rarely diagnosed, due to the low familiarity of the neonatologist with the subject and the difficulties in the applicability of diagnostic questionnaires. This case report aimed to assess the presence of this disorder in this group of patients and identify the difficulties encountered in the diagnosis and treatment. We report the case of a premature newborn with necrotizing enterocolitis during hospitalization and underwent three surgical approaches. The newborn exhibited intense irritability, having received high doses of fentanyl, dexmedetomidine, clonidine, ketamine, phenytoin, and methadone, without the control of the symptoms. A diagnosis of delirium was then made and treatment with quetiapine was started, with a complete reversal of the symptoms. This is the first case reported in Brazil and the first describing the withdrawal of the quetiapine.eng
dc.description.abstractRESUMO Delirium é uma síndrome comum em unidades de terapia intensiva, associando-se a maiores morbidade e mortalidade. No entanto, nas unidades de terapia intensiva neonatal, ele raramente é diagnosticado em razão da baixa familiaridade do neonatologista com a suspeita diagnóstica e das dificuldades na aplicabilidade dos questionários diagnósticos. Este relato de caso tem como objetivos mostrar que delirium está presente nesse grupo de pacientes e apontar as dificuldades encontradas no seu diagnóstico e tratamento. Relatamos o caso de um recém-nascido prematuro com enterocolite necrosante, submetido a três abordagens cirúrgicas. O recém-nascido apresentou intensa irritabilidade, tendo recebido altas doses de fentanil, dexmedetomidina, clonidina, cetamina, fenitoína e metadona, sem controle dos sintomas. Em seguida, foi feita a hipótese diagnóstica de delirium e iniciado tratamento com quetiapina, com reversão completa dos sintomas. Este é o primeiro caso notificado no Brasil e o primeiro que descreve a suspensão da quetiapina.por
dc.description.indexPubMed
dc.description.indexSciELO
dc.identifier.citationDEMENTIA & NEUROPSYCHOLOGIA, v.17, p.e20220046, 2023
dc.identifier.doi10.1590/1980-5764-dn-2022-0046
dc.identifier.issn1980-5764
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/53334
dc.language.isoengpor
dc.publisherAcademia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimentoeng
dc.relation.ispartofDementia & Neuropsychologia
dc.rightsopenAccesseng
dc.rights.holderCopyright Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimentoeng
dc.subjectDeliriumeng
dc.subjectAnalgesiaeng
dc.subjectQuetiapine Fumarateeng
dc.subjectInfant, Newborneng
dc.subjectNeonatal Abstinence Syndromeeng
dc.subjectDeliriumeng
dc.subjectFumarato de Quetiapinaeng
dc.subjectRecém-Nascidoeng
dc.subjectSíndrome de Abstinência Neonataleng
dc.subject.wosClinical Neurologyeng
dc.subject.wosGeriatrics & Gerontologyeng
dc.subject.wosHealth Care Sciences & Serviceseng
dc.subject.wosMedicine, General & Internaleng
dc.subject.wosNursingeng
dc.subject.wosPsychiatryeng
dc.subject.wosPsychologyeng
dc.titleSevere irritability in a critically ill preterm infant: a case of delirium at the neonatal intensive care uniteng
dc.title.alternativeGrave irritabilidade em prematuro criticamente doente: um caso de delirium na unidade de terapia intensiva neonataleng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcLUCAS HIRANO ARRUDA MORAES
hcfmusp.contributor.author-fmusphcVANESSA LISBETHE BEZERRA MAROPO
hcfmusp.contributor.author-fmusphcIVETE ZOBOLI
hcfmusp.contributor.author-fmusphcMARIO CICERO FALCAO
hcfmusp.contributor.author-fmusphcWERTHER BRUNOW DE CARVALHO
hcfmusp.description.beginpagee20220046
hcfmusp.description.volume17
hcfmusp.origemsciELO
hcfmusp.origem.pubmed37223840
hcfmusp.origem.scieloSCIELO:S1980-57642023000100600
hcfmusp.origem.scopus2-s2.0-85163030882
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hcfmusp.scopus.lastupdate2024-05-17
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