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agenda
20 avril 2022

EPURATION EXTRARÉNALE ET PLASMAPHÉRÈSE EN RÉANIMATION PÉDIATRIQUE

Intervenants Pr Etienne Javouhey (Lyon) Dr Karine Kolev (Lyon) Olivier Tisseur (IDE, Lyon) Malorie De-Monte (IDE, Lyon) Pr Mehdi Oualha (Necker, Paris) IDE Necker (Necker, Paris) Objectifs Pédagogiques Connaître les indications et les différentes techniques d’épuration extrarénale chez l’enfant. Maîtriser les alarmes les plus fréquemment rencontrées en cours de traitement. Connaître les principaux paramètres à surveiller lors d’une hémofiltration chez l’enfant et les principaux risques encourus. Savoir choisir le mode d’anticoagulation adapté à chaque situation clinique, connaître les modalités pratiques et les risques de chaque technique. Connaître les indications actuelles des plasmaphérèses et des nouvelles membranes Connaître les indications « non rénales » d’épuration Savoir gérer l’administration des médicaments et la nutrition chez un enfant en épuration extrarénale. Programme 09h00 : Accueil des participants 09h15 - 10h00 : Les enjeux de la dialyse des nourrissons                         Dr Karine Kolev (Lyon) 10h00 - 10h45 : Actualités dans l’épuration extra-rénale continue en eréanimation                         Pr Etienne Javouhey (Lyon) 10h45 - 11h00 Pause 11h00 - 11h30 : Indications non rénales d’épuration extrarénale                         Pr Etienne Javouhey (Lyon) 11h30 - 12h00 Adaptation des traitements médicamenteux en EER                         Pr Medhi Oualha (Paris, Necker) 12h00 - 12h30 : Techniques de montage et astuces pour le bon fonctionnement                         Olivier Tisseur (IDE, Lyon) - Malorie De-Monte (IDE, Lyon) 12h30 - 13h30 : Repas 14h00 - 15h00 : Gestion des alarmes et formation du personnel Pr Etienne Javouhey (Lyon) - Olivier Tisseur (IDE, Lyon) - Malorie De-Monte (IDE, Lyon) 15h00 - 17h00 Cas cliniques interactifs Cas lyonnais (E. Javouhey, O Tisseur) : EER et insuffisance hépatique aigue Cas Parisien (M Oualaa, IDE Necker) : anticoagulation au citrate Cas lyonnais (O Tisseur, K.Kolev) : MVO chez un nourrisson Inscriptions Inscription avant le 24 avril directement en ligne en suivant ce lien : https://www.srlf.org/civicrm-event/602 Nombre d'inscription limité à 18 places Renseignements Pr Etienne Javouhey - etienne.javouhey@chu-lyon.fr - Tel : 04.72.12.97.35 Frais d'inscription Internes membres du GFRUP : 50 € Internes non membres : 100 € Médecins membres du GFRUP : 150 € Médecins non membres : 250 € Institution médecins : 250 € Infirmiers(ières)/kinés(ées) membres du GFRUP : 25 € Infirmiers(ières)/kinés(ées) non membres : 50 € Infirmiers(ières)/kinés(ées) institution : 150 € Partenaire

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Are the GFRUP's recommendations for withholding or withdrawing treatments in critically ill children applicable? Results of a two-year survey

Soumis par Anonyme le lun 15/07/2024 - 10:01

J Med Ethics. 2007 Mar;33(3):128-33. doi: 10.1136/jme.2006.015990.

ABSTRACT

OBJECTIVE: To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French-speaking group of paediatric intensive and emergency care; GFRUP) for limitation of treatments in the paediatric intensive care unit (PICU).

DESIGN: A 2-year prospective survey.

SETTING: A 12-bed PICU at the Hôpital Jeanne de Flandre, Lille, France.

PATIENTS: Were included when limitation of treatments was expected.

RESULTS: Of 967 children admitted, 55 were included with a 2-day median delay. They were younger than others (24 v 60 months), had a higher paediatric risk of mortality (PRISM) score (14 v 4), and a higher paediatric overall performance category (POPC) score at admission (2 v 1); all p<0.002. 34 (50% of total deaths) children died. A limitation decision was made without meeting for 7 children who died: 6 received do-not-resuscitate orders (DNROs) and 1 received withholding decision. Decision-making meetings were organised for 31 children, and the following decisions were made: 12 DNROs (6 deaths and 6 survivals), 4 withholding (1 death and 3 survivals), with 14 withdrawing (14 deaths) and 1 continuing treatment (survival). After limitation, 21 (31% of total deaths) children died and 10 survived (POPC score 4). 13 procedures were interrupted because of death and 11 because of clinical improvement (POPC score 4). Parents' opinions were obtained after 4 family conferences (for a total of 110 min), 3 days after inclusion. The first meeting was planned for 6 days after inclusion and held on the 7th day after inclusion; 80% of parents were immediately informed of the decision, which was implemented after half a day.

CONCLUSIONS: GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision-making process.

PMID:17329379 | PMC:PMC2598266 | DOI:10.1136/jme.2006.015990

Date de publication
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pubmed:17329379
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Are the GFRUP's recommendations for withholding or withdrawing treatments in cr…

Management of intussusception in France in 2004: investigation of the Paediatric Infectious Diseases Group, the French Group of Paediatric Emergency and Reanimation, and the French Society of Paediatric Surgery

Soumis par Anonyme le lun 15/07/2024 - 10:01

Arch Pediatr. 2006 Dec;13(12):1581-8. doi: 10.1016/j.arcped.2006.10.009. Epub 2006 Nov 27.

ABSTRACT

OBJECTIVES: To describe the different pathways of management of intussusception (IS) in infants and children in metropolitan France and to identify paediatric emergency centres that might constitute a surveillance network for IS.

MATERIAL AND METHODS: A questionnaire was sent to 273 paediatric emergency centres distributed across France in 2005. Modalities of diagnosis and treatment of IS had to be precised.

RESULTS: One hundred and sixty-seven centres (61.2%) responded. The response was given by 131 paediatricians (78.4%) and 36 surgeons (21.6%) working in 38 universitary hospitals (22.7%) and 129 general hospitals (77.2%). The mean number of IS treated in each centre in 2004 was 11+/-13.5 (extr. 0 to 70; median 6). Diagnosis of IS required a collaboration between medical and surgical teams in 51.5% of the centres, but in 40.1% the sole medical team was in charge of the diagnosis. Ultrasonography is used for diagnosis by 98.8% of the centres. Reduction with hydrostatic enema and eventually surgery was performed in the same hospital in 44.3%. Other centres systematically or frequently transferred the patients for reduction, mostly towards universitary hospitals (90%).

CONCLUSION: The procedures of IS diagnosis are the same everywhere in France but the pathways of therapeutic management do vary, depending on the availability of surgeons and anaesthetists trained in paediatrics on each site. These disparities will probably change with the implementation of the new plan for sanitary organization in children and adolescents in France. Labellized paediatric emergency centres will gather more surgical patients and could eventually constitute an effective surveillance network for IS.

PMID:17125980 | DOI:10.1016/j.arcped.2006.10.009

Date de publication
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pubmed:17125980
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Management of intussusception in France in 2004: investigation of the Paediatri…

Withholding or withdrawing life saving treatment in pediatric intensive care unit: GFRUP guidelines

Soumis par Anonyme le lun 15/07/2024 - 10:01

Arch Pediatr. 2005 Oct;12(10):1501-8. doi: 10.1016/j.arcped.2005.04.085. Epub 2005 Jun 2.

ABSTRACT

Several recent French studies have revealed that 40% of death in pediatric intensive care units are associated with withdrawal or limitation of life saving treatments. Because such decisions are common, the Groupe francophone de réanimation et urgences pédiatriques (GFRUP) has decided to publish recommendations in order to help paediatricians dealing with those difficult issues and to improve their decisions. In a first part of the document the ethical principles that imply those guidelines are recalled, followed by definitions of the terms currently employed. The second part contains guidelines regarding decision making process, the way it is applied and organisation of relatives as well as paramedical and medical staff support when the death of a child occurs.

PMID:15935627 | DOI:10.1016/j.arcped.2005.04.085

Date de publication
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pubmed:15935627
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Withholding or withdrawing life saving treatment in pediatric intensive care un…

Société de réanimation de langue française. XXIII. Consensus conference on on resuscitation and emergency medicine--thursday October 23, 2003: erythrocyte transfusion and resuscitation (excluding newborn)

Soumis par Anonyme le lun 15/07/2024 - 10:01

Ann Fr Anesth Reanim. 2004 Jul;23(7):765-71. doi: 10.1016/j.annfar.2004.03.010.

NO ABSTRACT

PMID:15324974 | DOI:10.1016/j.annfar.2004.03.010

Date de publication
Identifiant
pubmed:15324974
Lien
Société de réanimation de langue française. XXIII. Consensus conference on on r…
annonces
21 juillet 2024

Poste de formation - Réanimation pédiatrique - CHU Vaudois (Lausanne)

Recherche médecins pédiatres en formation de réanimation pédiatrique, si possible en fin de formation, pour compléter l'équipe médicale des soins intensifs et intermédiaire de pédiatrie dans le Centre Hospitalier Universitaire Vaudois. Durée de 1 à 3 ans à convenir. Deux unités de 12 lits , réanimation et soins intermédiaires de pédiatrie, les deux polyvalentes. Toutes les spécialités y sont représentées hormis greffe hépatique et pulmonaire.

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agenda
20 avril 2022

NEURO-RÉANIMATION PÉDIATRIQUE

Formation de neuro-réanimation pédiatrique Intervenants Etienne Javouhey (Lyon) Sonia Courtil-Teyssedre (Lyon) Nathalie Richard (Lyon) Federico Di Rocco (Lyon) Gilles Orliaguet (Necker, Paris) Thomas Baugnon (Necker, Paris) Nicolas Joram (Nantes) Objectifs Pédagogiques Savoir interpréter les données du monitorage multimodal cérébral chez l’enfant Connaître les recommandations actuelles sur la prise en charge des traumatismes crâniens graves de l’enfant, y compris les TC infligés Savoir prévenir et contrôler les agressions cérébrales secondaires d’origine systémique Connaître les éléments clés du pronostic neurologique d’un enfant cérébro-lésé Connaître les indications chirurgicales d’un enfant avec HTIC Programme 08h30 : Accueil des participants 09h00 - 09h45 : Les indications chirurgicales chez l’enfant avec hypertension crânienne &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Federico Di Rocco (Lyon, HFME) 09h45 - 11h15 Ateliers session 1* 11h15 - 12h45 Ateliers session 2* 12h45 - 13h45 Pause déjeuner 13h45 - 14h30 Stratégie d’imagerie cérébral chez l’enfant cérébro-lésé &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Neuroradiologue pédiatrique 14h30 - 16h00 Ateliers session 2 * 16h00 - 17h30 Ateliers session 3* Atelier 1: Doppler transcrânien, DENO, ETF &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Sonia Courtil-Teyssedre (Lyon, HFME) Atelier 2: Monitorage multimodal de l’enfant cérébrolésé &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;Nicolas Joram (CHU de Nantes) Atelier 3: Cas clinique interactifs &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Etienne Javouhey (Lyon, HFME) - Gilles Orliaguet (Paris, Necker Enfants Malades) Atelier 4 : simulation haute fidélité &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Nathalie Richard (Lyon, HFME) - Thomas Baugnon (Paris, Necker Enfants Malades) Inscriptions Inscription avant le 24 avril directement en ligne en suivant ce lien :&nbsp;https://www.srlf.org/civicrm-event/601 Nombre d'inscription limité à 24 places Renseignements Pr Etienne Javouhey -&nbsp;etienne.javouhey@chu-lyon.fr&nbsp;- Tel : 04.72.12.97.35 Frais d'inscription Internes membres du GFRUP : 50 € Internes non membres : 100 € Médecins membres du GFRUP : 150 € Médecins non membres : 250 € Institution médecins : 250 €

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