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.