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Anaesth Crit Care Pain Med. 2024 May 31;43(4):101401. doi: 10.1016/j.accpm.2024.101401. Online ahead of print.

ABSTRACT

OBJECTIVE: It is now well established that post-intensive care syndrome is frequent in critically ill children after discharge from the pediatric intensive care unit (PICU). Nevertheless, post-intensive care follow-up is highly heterogenous worldwide and is not considered routine care in many countries. The purpose of this viewpoint was to report the reflections of the French PICU society working group on how to implement post-PICU follow-up.

METHODS: A working group was set up within the Groupe Francophone de Reanimation et d'Urgences Pédiatriques (GFRUP) to provide conceptual and practical guidance for developing post-PICU follow-up. The working group included psychologists, PICU physicians, physiotherapists, and nurses, from different French PICUs. Five virtual meetings have been held.

RESULTS: First, we described in this work the objectives of the follow-up program and the population to be targeted. We also provided a framework to implement post-PICU follow-up in clinical practice. Finally, we detailed the potential obstacles and challenges to consider.

CONCLUSION: Although implementing a post-PICU follow-up program is a challenge, the benefits could be significant for both patient and relatives, as well as for the health care professionals involved.

PMID:38823635 | DOI:10.1016/j.accpm.2024.101401

Ann Intensive Care. 2014 May 24;4:15. doi: 10.1186/2110-5820-4-15. eCollection 2014.

ABSTRACT

The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de Réanimation de Langue Française (SRLF) in conjunction with the Société Française d'Anesthésie et de Réanimation (SFAR), the Société de Pneumologie de Langue Française (SPLF), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP), the Société Française de Perfusion (SOFRAPERF), the Société Française de Chirurgie Thoracique et Cardiovasculaire (SFCTV) et the Sociedad Española de Medecina Intensiva Critica y Unidades Coronarias (SEMICYUC), a Consensus Conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques?; 2) Which patients could benefit from extracorporeal life support?; 3) How to perform extracorporeal life support?; 4) How and when to stop extracorporeal life support?; 5) Which organization should be recommended? To write the recommendations, evidence-based medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the Consensus Conference were taken into account.

PMID:24936342 | PMC:PMC4046033 | DOI:10.1186/2110-5820-4-15

Anaesth Crit Care Pain Med. 2018 Apr;37(2):171-186. doi: 10.1016/j.accpm.2017.12.001. Epub 2017 Dec 27.

ABSTRACT

The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société francaise d'anesthésie et de réanimation [SFAR]) in partnership with the Association de neuro-anesthésie-réanimation de langue française (ANARLF), The French Society of Emergency Medicine (Société française de médecine d'urgence (SFMU), the Société française de neurochirurgie (SFN), the Groupe francophone de réanimation et d'urgences pédiatriques (GFRUP) and the Association des anesthésistes-réanimateurs pédiatriques d'expression française (ADARPEF). The method used to elaborate these guidelines was the Grade^® method. After two Delphi rounds, 32 recommendations were formally developed by the experts focusing on the evaluation the initial severity of traumatic brain injury, the modalities of prehospital management, imaging strategies, indications for neurosurgical interventions, sedation and analgesia, indications and modalities of cerebral monitoring, medical management of raised intracranial pressure, management of multiple trauma with severe traumatic brain injury, detection and prevention of post-traumatic epilepsia, biological homeostasis (osmolarity, glycaemia, adrenal axis) and paediatric specificities.

PMID:29288841 | DOI:10.1016/j.accpm.2017.12.001

Anaesth Crit Care Pain Med. 2016 Apr;35(2):151-65. doi: 10.1016/j.accpm.2016.03.004. Epub 2016 May 24.

NO ABSTRACT

PMID:27235292 | DOI:10.1016/j.accpm.2016.03.004

Infect Dis Now. 2021 Aug;51(5):407-409. doi: 10.1016/j.idnow.2021.05.001. Epub 2021 May 10.

NO ABSTRACT

PMID:33984551 | DOI:10.1016/j.idnow.2021.05.001

Rev Prat. 2015 May;65(5):627-30.

ABSTRACT

The number of children admitted to paediatric emergencies is increasing steadily, and is responsible for an altered quality in the patients' reception and some major perturbations in the care organization. In this context, the primary care physicians play a major role in explaining their patients "how to use" the paediatric emergency department (priority in case of vital emergency, periods with lot of admissions and increased waiting time ...). Everything must be done to find an altemative to the pediatric emergency department passage by facilitating communication between caregivers and for example by offering semi urgent consultations possibility.

PMID:26165096

Med Mal Infect. 2007 Dec;37 Suppl 3:S194-203. doi: 10.1016/j.medmal.2007.09.005.

NO ABSTRACT

PMID:18293503 | PMC:PMC7131670 | DOI:10.1016/j.medmal.2007.09.005

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

Arch Pediatr. 2024 Apr;31(3):202-204. doi: 10.1016/j.arcped.2024.01.002. Epub 2024 Mar 19.

ABSTRACT

Although pediatric post-intensive care syndrome is frequent and impacts the child's quality of life in various aspects, there are currently no guidelines regarding post-pediatric intensive care unit (PICU) follow-up. The aim of this study was to describe post-PICU follow-up in France. Among the 37 French PICUs, only 67 % had a consultation service, mostly performed by pediatric intensivists (95 %). Post-intensive care evaluation was the main objective for 46 % of these centers, whereas others focused on specific patient populations. Post-intensive care follow-up is highly heterogeneous and developing such consultation services appears to be a main challenge for PICU teams.

PMID:38508912 | DOI:10.1016/j.arcped.2024.01.002

Arch Pediatr. 2022 May;29(4):326-329. doi: 10.1016/j.arcped.2022.02.007. Epub 2022 Mar 26.

ABSTRACT

BACKGROUND: Due to the lack of available evidence on pediatric trauma care organization, no French national guideline has been developed. This survey aimed to describe the management of pediatric trauma patients in France.

METHODS: In this cross-sectional survey, an electronic questionnaire (previously validated) was distributed to intensive care physicians from tertiary hospitals via the GFRUP (Groupe Francophone de Réanimation et Urgences Pédiatriques) mailing list.

RESULTS: We collected 37 responses from 28 centers with available data, representing 100% of French level-1 pediatric trauma centers. Most of the pediatric centers (n = 21, 75%) had a written local protocol on pediatric trauma care. In most centers (n = 17, 61%), patients with severe trauma could be admitted in various locations, including the adult or pediatric emergency department or the intensive care unit. Usually, the location of the trauma room depended on the patients' age and/or severity of trauma. In 12 centers in which trauma could be managed by adult physicians (n = 12/18, 70%), a physician with pediatric expertise (anesthesiologist or intensive care physician) could be called according to the patient's age or severity of trauma. The cut-off patient age for considering pediatric expertise was mainly 3-5 years (n = 10, 83%).

CONCLUSION: Although most French level-1 pediatric trauma centers have a local protocol for pediatric trauma management, organization is very heterogeneous in France. Guidelines should focus on collaboration between professionals and hospital facilities in order to improve outcomes of children with trauma.

PMID:35351342 | DOI:10.1016/j.arcped.2022.02.007