Enhance quality care performance: Determination of the variables for establishing a common database in French paediatric critical care units

Abstract Selected variables for the French Paediatric Intensive Care registry. Rationale, aims, and objectives Providing quality care requires follow-up in regard to clinical and economic activities. Over the past decade, medical databases and patient registries have expanded considerably, particularly in paediatric critical care medicine (eg, the Paediatric Intensive Care Audit Network (PICANet) in the UK, the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry in Australia and New Zealand, and the Virtual Paediatric Intensive Care Unit Performance System (VPS) in the USA). Such a registry is not yet available in France. The aim of this study was to determine variables that ought to be included in a French paediatric critical care registry. Methods Variables, items, and subitems from 3 foreign registries and 2 French local databases were used. Items described each variable, and subitems described items. The Delphi method was used to evaluate and rate 65 variables, 90 items, and 17 subitems taking into account importance or relevance based on input from 28 French physicians affiliated with the French Paediatric Critical Care Group. Two ratings were used between January and May 2013. Results Fifteen files from 10 paediatric intensive care units were included. Out of 65 potential variables, 48 (74%) were considered to be indispensable, 16 (25%) were considered to be optional, and 1 (2%) was considered to be irrelevant. Out of 90 potential items, 62 (69%) were considered to be relevant, 23 (26%) were considered to be of little relevance, and 5 (6%) were considered to be irrelevant. Out of 17 potential subitems, 9 (53%) were considered to be relevant, 6 (35%) were considered to be of little relevance, and 2 (12%) were considered to be irrelevant. Conclusions The necessary variables that ought to be included in a French paediatric critical care registry were identified. The challenge now is to develop the French registry for paediatric intensive care units

Transvesical Intra-Abdominal Pressure Measurement in Newborn: What Is the Optimal Saline Volume Instillation?

International audienceOBJECTIVE: To determine the optimal saline volume bladder instillation to measure intravesical pressure in critically ill newborns weighing less than 4.5 kg, and to establish a reference of intra-abdominal pressure value in this population. DESIGN: Prospective monocentric study. SETTING: Neonatal and PICU. PATIENTS: Newborns, premature or not, weighing less than 4.5 kg who required a urethral catheter. MEASUREMENTS AND MAIN RESULTS: Patients were classified into two groups according to whether they presented a risk factor for intra-abdominal hypertension. Nine intravesical pressure measures per patient were performed after different volume saline instillation. The first one was done without saline instillation and then by increments of 0.5 mL/kg to a maximum of 4 mL/kg. Linear models for repeated measurements of intravesical pressure with unstructured covariance were used to analyze the variation of intravesical pressure measures according to the conditions of measurement (volume instilled). Pairwise comparisons of intravesical pressure adjusted mean values between instillation volumes were done using Tukey tests, corrected for multiple testing to determine an optimal instillation volume. Forty-seven patients with completed measures (nine instillations volumes) were included in the analysis. Mean intravesical pressure values were not significantly different when measured after instillation of 0.5, 1, or 1.5 mL/kg, whereas measures after instillation of 2 mL/kg or more were significantly higher. The median intravesical pressure value in the group without intra-abdominal hypertension risk factor after instillation of 1 mL/kg was 5 mm Hg (2-6 mm Hg). CONCLUSIONS: The optimal saline volume bladder instillation to measure intra-abdominal pressure in newborns weighing less than 4.5 kg was 1 mL/kg. Reference intra-abdominal pressure in this population was found to be 5 mm Hg (2-6 mm Hg

Frequency of Extracorporeal Membrane Oxygenation Support and Outcomes After Implementation of a Structured PICU Network in Neonates and Children: A Prospective Population-Based Study in the West of France

International audienc

Frequency of Extracorporeal Membrane Oxygenation Support and Outcomes After Implementation of a Structured PICU Network in Neonates and Children

International audienc

IBISCA-Panama, a large-scale study of arthropod beta-diversity and vertical stratification in a lowland rainforest: rationale, description of study sites and field methodology

info:eu-repo/semantics/publishe

IBISCA-Panama, a large-scale study of arthropod beta-diversity and vertical stratification in a lowland rainforest : rationale, study sites and field protocols.

IBISCA-Panama (?Investigating the BIodiversity of Soil and Canopy Arthropods?, Panama module) represents a large-scale research initiative to quantify the spatial distribution of arthropod biodiversity in a Neotropical forest, using a combination of (1) international collaboration, (2) a set of common research questions, and (3) an integrated experimental design. Here, we present the rationale of the programme, describe the study sites, and outline field protocols. In the San Lorenzo Protected Area of Panama, twelve 20 x 20 m sites, all less than 2 km apart, were surveyed for plants and arthropods, from the ground to the upper canopy. Access to the canopy and its fauna was facilitated by fogging, single-rope techniques and a variety of devices such as a canopy crane, the ?SolVin-Bretzel? canopy raft, the canopy bubble and Ikos. IBISCA-Panama represented the first attempt to combine these complementary techniques of canopy access in a large-scale investigation. Such techniques provided spatial replication during initial field work performed in September-October 2003. Temporal replication across seasons consisted of subsequent field work of varying intensity during dry, early wet and late wet periods in 2004. Arthropods were surveyed using 14 different protocols targeting the soil, litter, understorey, mid-canopy and upper canopy habitats. These protocols included: WINKLER sifting; BERLESE-TULLGREN; hand-collecting of galls and social insects; fogging; beating; woodrearing; baits; and various types of traps such as pitfall, small and large flight-interception, sticky, light, and Malaise traps. Currently, analyses of arthropod distribution in this forest concentrate on a set of 63 focal taxa representing different phylogenies and lifehistories. IBISCA-Panama may be considered as a model for largescale research programmes targeting invertebrate biodiversity. Its collaborative modus operandi can be applied to answer a variety of pressing ecological questions related to forest biodiversity, as evidenced by the recent development of further IBISCA programmes in other parts of the world