Assessment of intensive care unit delirium in developmentally delayed children.

Pediatric intensive care unit (ICU) delirium is an increasingly common diagnosis with negative impacts on morbidity and mortality. Patients with developmental delay are particularly susceptible to developing ICU delirium due to possible cerebral disease, sensory loss, unfamiliar environment, or use of deliriogenic medications. Of the existing scoring tools to assess for ICU delirium, few have been evaluated for patients with developmental delay. This review highlights the literature investigating measures of accuracy of ICU delirium scoring tools in pediatric patients, potential impact of developmental delay on successfully diagnosing delirium, and future directions for this area of care. IMPACT: This article summarizes pediatric intensive care unit (ICU) delirium, delirium screening tools, and developmental delay. This article highlights the limitations to current ICU delirium screening tools in patients with developmental delay and highlights future directions for the field.

The Clinical Utility of MRSA Nasal Surveillance Swabs in Ruling-Out MRSA Infections in Children.

The utility of methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance swabs has not been well-described in children. This retrospective, cohort study yielded a negative predictive value of 99.4% for an initial negative MRSA nasal surveillance swab in 165 hospitalized children with a suspected infection and clinical cultures obtained from a likely site of infection.

Rechallenge of Elexacaftor/Tezacaftor/Ivacaftor After Skin Rash in Two Pediatric Patients.

Cystic fibrosis transmembrane conductance regulator (CFTR) modulators have revolutionized care for patients with cystic fibrosis (CF). The triple combination product elexacaftor/tezacaftor/ivacaftor is a highly effective CFTR modulator that is generally well tolerated. However, in clinical trials of pediatric and adult patients, 4% to 12% developed rash after initiation of therapy. Few reports have described approaches to management of this adverse effect. In this report, we describe 2 children with CF who developed a pruritic, maculopapular rash after initiating elexacaftor/tezacaftor/ivacaftor. These patients were successfully rechallenged after rash resolution with a practical titration schedule.