Melatonin may reduce delirium burden in children admitted to ICU

The use of melatonin in paediatric intensive care unit (PICU) appears to lower the burden of positive delirium scores in children, a study has shown.

A total of 642 admissions (556 patients, mean age 8.8 years), accounting for about 8 percent of PICU admissions during the study period, were included in the assessment. The mean melatonin dose administered was 3 mg.

The majority (60 percent) of patients started melatonin within 48 h of PICU admission, and most of them (83 percent) continued melatonin use following transfer to the floor.

Melatonin use correlated with a decrease in the percent of delirium scores ≥9 in patients receiving melatonin for presumed delirium, and those receiving at least 7 days of therapy showed a greater reduction. Furthermore, one in four (25 percent) children not on melatonin prior to admission were prescribed melatonin upon discharge.

“Melatonin, when prescribed in the PICU is typically started within 48 h of admission at a dose of 3 mg,” the researchers said. “Continuation of therapy after ICU transfer and discharge to home is common.”

This retrospective, observational study involved children aged 1 month to 18 years who were admitted to two PICUs between 1 January 2021 and 1 January 2023.

“Sleep disruption and delirium are common among children requiring intensive care,” the researchers said. “Melatonin secretion is altered in critical illness and supplementation may be beneficial.”