Author: "Jouvet, Philippe" / Topic: critical care - Searchworks@Jio Institute Digital Library Search Results

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1. Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study.

Author: Murthy S, Archambault PM, Atique A, Carrier FM, Cheng MP, Codan C, Daneman N, Dechert W, Douglas S, Fiest KM, Fowler R, Goco G, Gu Y, Guerguerian AM, Hall R, Hsu JM, Joffe A, Jouvet P, Kelly L, Kho ME, Kruisselbrink RJ, Kumar D, Kutsogiannis DJ, Lamontagne F, Lee TC, Menon K, O'Grady H, O'Hearn K, Ovakim DH, Pharand SG, Pitre T, Reel R, Reeve B, Rewa O, Richardson D, Rishu A, Sandhu G, Sarfo-Mensah S, Shadowitz E, Sligl W, Solomon J, Stelfox HT, Swanson A, Tessier-Grenier H, Tsang JLY, and Wood G
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, COVID-19 diagnosis, COVID-19 therapy, Canada epidemiology, Comorbidity, Critical Illness, Disease Management, Disease Progression, Female, Humans, Incidence, Intensive Care Units, Male, Middle Aged, Mortality, Pandemics, Pregnancy, Public Health Surveillance, Severity of Illness Index, Young Adult, COVID-19 epidemiology, COVID-19 virology, Critical Care, Hospitalization, SARS-CoV-2
Abstract: Background: Clinical data on patients admitted to hospital with coronavirus disease 2019 (COVID-19) provide clinicians and public health officials with information to guide practice and policy. The aims of this study were to describe patients with COVID-19 admitted to hospital and intensive care, and to investigate predictors of outcome to characterize severe acute respiratory infection., Methods: This observational cohort study used Canadian data from 32 selected hospitals included in a global multisite cohort between Jan. 24 and July 7, 2020. Adult and pediatric patients with a confirmed diagnosis of COVID-19 who received care in an intensive care unit (ICU) and a sampling of up to the first 60 patients receiving care on hospital wards were included. We performed descriptive analyses of characteristics, interventions and outcomes. The primary analyses examined in-hospital mortality, with secondary analyses of the length of hospital and ICU stay., Results: Between January and July 2020, among 811 patients admitted to hospital with a diagnosis of COVID-19, the median age was 64 (interquartile range [IQR] 53-75) years, 495 (61.0%) were men, 46 (5.7%) were health care workers, 9 (1.1%) were pregnant, 26 (3.2%) were younger than 18 years and 9 (1.1%) were younger than 5 years. The median time from symptom onset to hospital admission was 7 (IQR 3-10) days. The most common symptoms on admission were fever, shortness of breath, cough and malaise. Diabetes, hypertension and cardiac, kidney and respiratory disease were the most common comorbidities. Among all patients, 328 received care in an ICU, admitted a median of 0 (IQR 0-1) days after hospital admission. Critically ill patients received treatment with invasive mechanical ventilation (88.8%), renal replacement therapy (14.9%) and extracorporeal membrane oxygenation (4.0%); 26.2% died. Among those receiving mechanical ventilation, 31.2% died. Age was an influential predictor of mortality (odds ratio per additional year of life 1.06, 95% confidence interval 1.03-1.09)., Interpretation: Patients admitted to hospital with COVID-19 commonly had fever, respiratory symptoms and comorbid conditions. Increasing age was associated with the development of critical illness and death; however, most critically ill patients in Canada, including those requiring mechanical ventilation, survived and were discharged from hospital., Competing Interests: Competing interests: See the end of the article. Competing interests: Todd Lee reports salary support from Fonds de recherche du Québec – Santé. Deepali Kumar reports grants and personal fees from Roche. Michelle Kho reports grants from Canada Research Chairs. Matthew Cheng reports grants from the McGill Interdisciplinary Initiative in Infection and Immunity and personal fees from GEn1E Lifesciences (as a member of the scientific advisory board) and personal fees from nplex biosciences (as a member of the scientific advisory board). Philippe Jouvet reports consulting for Mallinckrodt Pharmaceuticals and grants to his institution from VitalTracer and Evolucare. Patrick Archambault is a co-investigator in the Canadian Institutes of Health Research (CIHR)–funded Canadian COVID-19 Emergency Department Rapid Response Network (https://canadiancovid19ednetwork.org). No other competing interests were declared., (© 2021 Joule Inc. or its licensors.)
Published: 2021
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2. Reorganizing Care With the Implementation of Electronic Medical Records: A Time-Motion Study in the PICU.

Author: Roumeliotis N, Parisien G, Charette S, Arpin E, Brunet F, and Jouvet P
Subjects: Caregivers, Child, Child, Preschool, Health Personnel statistics & numerical data, Humans, Infant, Infant, Newborn, Prospective Studies, Time Factors, Critical Care methods, Electronic Health Records statistics & numerical data, Hospital Restructuring methods, Intensive Care Units, Pediatric statistics & numerical data, Quality Improvement statistics & numerical data
Abstract: Objectives: To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records., Design: A prospective, observational, time-motion study., Setting: A level 3 PICU., Participants: Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013., Interventions: The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare)., Measurements and Main Results: Time spent completing various work tasks was recorded by direct observation, and proportion of time in tasks was compared for each study period. A total of 153.7 hours was observed from 22 nurses and 14 orderlies. There was no significant difference in the proportion of nursing patient care time before (68.8% [interquartile range, 48-72%]) and after (55% [interquartile range, 51-57%]) (p = 0.11) the reorganization with electronic medical record. Direct patient care task time for nurses was increased from 27.0% (interquartile range, 30-37%) before to 34.7% (interquartile range, 33-75%) (p = 0.336) after, and indirect patient care tasks decreased from 33.6% (interquartile range, 23-41%) to 18.6% (interquartile range, 16-22%) (p = 0.036). Documentation time significantly increased from 14.5% (interquartile range, 12-22%) to 26.2% (interquartile range, 23-28%) (p = 0.032). Nursing productivity ratio improved from 28.3 to 26.0. A survey revealed that nursing staff was satisfied with the electronic medical record, although there was a concern for the maintenance of oral communication in the unit., Conclusions: The reorganization of care with the implementation of an ICU-specific electronic medical record in the PICU did not change total patient care provided but improved nursing productivity, resulting in improved efficiency. Documentation time was significantly increased, and concern over reduced oral communication arose, which should be a focus for future electronic improvement strategies.
Published: 2018
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3. Mechanical Ventilation and Decision Support in Pediatric Intensive Care.

Author: Newth CJL, Khemani RG, Jouvet PA, and Sward KA
Subjects: Child, Clinical Protocols, Critical Care standards, Humans, Pediatrics, Respiration, Artificial adverse effects, Respiration, Artificial standards, Clinical Decision-Making methods, Critical Care methods, Decision Support Systems, Clinical, Medical Errors prevention & control, Respiration, Artificial methods
Abstract: Respiratory support is required in most children in the pediatric intensive care unit. Decision-support tools (paper or electronic) have been shown to improve the quality of medical care, reduce errors, and improve outcomes. Computers can assist clinicians by standardizing descriptors and procedures, consistently performing calculations, incorporating complex rules with patient data, and capturing relevant data. This article discusses computer decision-support tools to assist clinicians in making flexible but consistent, evidence-based decisions for equivalent patient states., (Copyright © 2017 Elsevier Inc. All rights reserved.)
Published: 2017
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4. Renal Function Follow-Up and Renal Recovery After Acute Kidney Injury in Critically Ill Children.

Author: Hessey E, Ali R, Dorais M, Morissette G, Pizzi M, Rink N, Jouvet P, Lacroix J, Phan V, and Zappitelli M
Subjects: Acute Kidney Injury blood, Acute Kidney Injury physiopathology, Acute Kidney Injury therapy, Adolescent, Aftercare statistics & numerical data, Biomarkers blood, Child, Child, Preschool, Critical Illness, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Logistic Models, Male, Patient Discharge, Prognosis, Quebec, Recovery of Function, Retrospective Studies, Acute Kidney Injury diagnosis, Aftercare methods, Creatinine blood, Critical Care, Practice Patterns, Physicians' statistics & numerical data
Abstract: Objectives: To evaluate factors associated with renal recovery from acute kidney injury in critically ill children and the extent to which serum creatinine is measured before discharge., Design: Retrospective cohort study., Setting: Two PICUs at tertiary centers in Montreal, QC, Canada., Patients: Children (< 18 yr old) admitted to the PICU between 2003 and 2005. Patients with end-stage renal disease, no healthcare number, died during admission, or admitted postcardiac surgery were excluded., Interventions: None., Measurements and Main Results: Acute kidney injury was defined using internationally accepted criteria (Kidney Disease: Improving Global Outcomes). Two renal recovery outcomes commonly used in the literature were evaluated: hospital discharge serum creatinine less than 1.5 and less than 1.15 times baseline. Proportions of patients with 1) serum creatinine measurements between PICU and hospital discharge and 2) renal recovery were calculated. Univariate and multivariate analyses were performed to determine factors associated with serum creatinine monitoring and nonrecovery after acute kidney injury. Of 2,033 patients included, 829 (40.8%) had serum creatinine measurements between PICU and hospital discharge. The odds of having a discharge serum creatinine measurement increased with acute kidney injury severity (stages 1, 2, 3 adjusted odds ratio [95% CI]: 1.49 [1.03-2.15], 2.52 [1.40-4.54], 7.87 [3.16-19.60], respectively). Acute kidney injury recovery was 92.5% when defined as serum creatinine less than 1.5 times baseline versus 75.9% when defined as less than 1.15 times baseline (p < 0.001). Stage 3 acute kidney injury was associated with having a discharge serum creatinine greater than or equal to 1.5 times baseline (adjusted odds ratio = 3.51 [1.33-9.19])., Conclusions: Less than half the PICU population had serum creatinine measured before hospital discharge. More severe acute kidney injury was associated with higher likelihood of serum creatinine monitoring and lower probability of acute kidney injury recovery. Future research should address knowledge translation on post-PICU acute kidney injury follow-up before hospital discharge.
Published: 2017
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5. The influence of corticosteroid treatment on the outcome of influenza A(H1N1pdm09)-related critical illness.

Author: Delaney JW, Pinto R, Long J, Lamontagne F, Adhikari NK, Kumar A, Marshall JC, Cook DJ, Jouvet P, Ferguson ND, Griesdale D, Burry LD, Burns KE, Hutchison J, Mehta S, Menon K, and Fowler RA
Subjects: Adult, Aged, Cohort Studies, Female, Hospital Mortality, Humans, Hydrocortisone pharmacology, Influenza A Virus, H1N1 Subtype drug effects, Influenza A Virus, H1N1 Subtype pathogenicity, Influenza, Human drug therapy, Influenza, Human mortality, Logistic Models, Male, Middle Aged, Adrenal Cortex Hormones adverse effects, Adrenal Cortex Hormones therapeutic use, Critical Care methods, Treatment Outcome
Abstract: Background: Patients with 2009 pandemic influenza A(H1N1pdm09)-related critical illness were frequently treated with systemic corticosteroids. While observational studies have reported significant corticosteroid-associated mortality after adjusting for baseline differences in patients treated with corticosteroids or not, corticosteroids have remained a common treatment in subsequent influenza outbreaks, including avian influenza A(H7N9). Our objective was to describe the use of corticosteroids in these patients and investigate predictors of steroid prescription and clinical outcomes, adjusting for both baseline and time-dependent factors., Methods: In an observational cohort study of adults with H1N1pdm09-related critical illness from 51 Canadian ICUs, we investigated predictors of steroid administration and outcomes of patients who received and those who did not receive corticosteroids. We adjusted for potential baseline confounding using multivariate logistic regression and propensity score analysis and adjusted for potential time-dependent confounding using marginal structural models., Results: Among 607 patients, corticosteroids were administered to 280 patients (46.1%) at a median daily dose of 227 (interquartile range, 154-443) mg of hydrocortisone equivalents for a median of 7.0 (4.0-13.0) days. Compared with patients who did not receive corticosteroids, patients who received corticosteroids had higher hospital crude mortality (25.5% vs 16.4%, p = 0.007) and fewer ventilator-free days at 28 days (12.5 ± 10.7 vs 15.7 ± 10.1, p < 0.001). The odds ratio association between corticosteroid use and hospital mortality decreased from 1.85 (95% confidence interval 1.12-3.04, p = 0.02) with multivariate logistic regression, to 1.71 (1.05-2.78, p = 0.03) after adjustment for propensity score to receive corticosteroids, to 1.52 (0.90-2.58, p = 0.12) after case-matching on propensity score, and to 0.96 (0.28-3.28, p = 0.95) using marginal structural modeling to adjust for time-dependent between-group differences., Conclusions: Corticosteroids were commonly prescribed for H1N1pdm09-related critical illness. Adjusting for only baseline between-group differences suggested a significant increased risk of death associated with corticosteroids. However, after adjusting for time-dependent differences, we found no significant association between corticosteroids and mortality. These findings highlight the challenges and importance in adjusting for baseline and time-dependent confounders when estimating clinical effects of treatments using observational studies.
Published: 2016
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6. Critical care capacity in Canada: results of a national cross-sectional study.

Author: Fowler RA, Abdelmalik P, Wood G, Foster D, Gibney N, Bandrauk N, Turgeon AF, Lamontagne F, Kumar A, Zarychanski R, Green R, Bagshaw SM, Stelfox HT, Foster R, Dodek P, Shaw S, Granton J, Lawless B, Hill A, Rose L, Adhikari NK, Scales DC, Cook DJ, Marshall JC, Martin C, and Jouvet P
Subjects: Canada epidemiology, Critical Care trends, Cross-Sectional Studies, Female, Health Resources trends, Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human epidemiology, Influenza, Human therapy, Male, Pandemics, Respiration, Artificial statistics & numerical data, Respiration, Artificial trends, Surveys and Questionnaires, Critical Care statistics & numerical data, Health Resources statistics & numerical data, Hospital Bed Capacity
Abstract: Introduction: Intensive Care Units (ICUs) provide life-supporting treatment; however, resources are limited, so demand may exceed supply in the event of pandemics, environmental disasters, or in the context of an aging population. We hypothesized that comprehensive national data on ICU resources would permit a better understanding of regional differences in system capacity., Methods: After the 2009-2010 Influenza A (H1N1) pandemic, the Canadian Critical Care Trials Group surveyed all acute care hospitals in Canada to assess ICU capacity. Using a structured survey tool administered to physicians, respiratory therapists and nurses, we determined the number of ICU beds, ventilators, and the ability to provide specialized support for respiratory failure., Results: We identified 286 hospitals with 3170 ICU beds and 4982 mechanical ventilators for critically ill patients. Twenty-two hospitals had an ICU that routinely cared for children; 15 had dedicated pediatric ICUs. Per 100,000 population, there was substantial variability in provincial capacity, with a mean of 0.9 hospitals with ICUs (provincial range 0.4-2.8), 10 ICU beds capable of providing mechanical ventilation (provincial range 6-19), and 15 invasive mechanical ventilators (provincial range 10-24). There was only moderate correlation between ventilation capacity and population size (coefficient of determination (R(2)) = 0.771)., Conclusion: ICU resources vary widely across Canadian provinces, and during times of increased demand, may result in geographic differences in the ability to care for critically ill patients. These results highlight the need to evolve inter-jurisdictional resource sharing during periods of substantial increase in demand, and provide background data for the development of appropriate critical care capacity benchmarks.
Published: 2015
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7. How to manage ventilation in pediatric acute respiratory distress syndrome?

Author: Kneyber MC, Jouvet PA, and Rimensberger PC
Subjects: Adolescent, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Critical Care methods, High-Frequency Ventilation methods, Pediatrics methods, Respiratory Distress Syndrome therapy
Published: 2014
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8. Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies.

Author: Weiss SL, Fitzgerald JC, Faustino EV, Festa MS, Fink EL, Jouvet P, Bush JL, Kissoon N, Marshall J, Nadkarni VM, and Thomas NJ
Subjects: Child, Humans, Critical Care statistics & numerical data, Critical Illness epidemiology, Cross-Sectional Studies, Pediatrics statistics & numerical data
Abstract: Objective: The point prevalence methodology is a valuable epidemiological study design that can optimize patient enrollment, prospectively gather individual-level data, and measure practice variability across a large number of geographic regions and healthcare settings. The objective of this article is to review the design, implementation, and analysis of recent point prevalence studies investigating the global epidemiology of pediatric critical illness., Data Sources: Literature review and primary datasets., Study Selection: Multicenter, international point prevalence studies performed in PICUs since 2007., Data Extraction: Study topic, number of sites, number of study days, patients screened, prevalence of disease, use of specified therapies, and outcomes., Data Synthesis: Since 2007, five-point prevalence studies have been performed on acute lung injury, neurologic disease, thromboprophylaxis, fluid resuscitation, and sepsis in PICUs. These studies were performed in 59-120 sites in 7-28 countries. All studies accounted for seasonal variation in pediatric disease by collecting data over multiple study days. Studies screened up to 6,317 patients and reported data on prevalence and therapeutic variability. Three studies also reported short-term outcomes, a valuable but atypical data element in point prevalence studies. Using these five studies as examples, the advantages and disadvantages and approach to designing, implementing, and analyzing point prevalence studies are reviewed., Conclusions: Point prevalence studies in pediatric critical care can efficiently provide valuable insight on the global epidemiology of disease and practice patterns for critically ill children.
Published: 2014
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9. High-volume hemofiltration for critically ill children with acute liver failure: a standard treatment?*.

Author: Merouani A and Jouvet P
Subjects: Female, Humans, Male, Critical Care, Hemofiltration, Liver Failure, Acute therapy
Published: 2014
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10. Acute rehabilitation practices in critically ill children: a multicenter study.

Author: Choong K, Foster G, Fraser DD, Hutchison JS, Joffe AR, Jouvet PA, Menon K, Pullenayegum E, and Ward RE
Subjects: Age Factors, Canada, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Neuromuscular Blockade, Occupational Therapy statistics & numerical data, Patient Outcome Assessment, Physical Therapy Modalities statistics & numerical data, Practice Patterns, Physicians', Retrospective Studies, Seasons, Speech Therapy statistics & numerical data, Time Factors, Walking, Critical Care methods, Critical Illness rehabilitation, Early Ambulation statistics & numerical data
Abstract: Objective: To evaluate acute rehabilitation practices in pediatric critical care units across Canada., Design: Retrospective cohort study., Setting: Six Canadian, tertiary care pediatric critical care units., Patients/subjects: Six hundred children aged under 17 years admitted to pediatric critical care unit during a winter and summer month of 2011 with a greater than 24-hour length of stay., Interventions: None., Measurements and Main Results: The primary outcome of interest was the nature and timing of pediatric critical care unit rehabilitation practices.Rehabilitation was classified according to mobility and nonmobility interventions. Predictors of mobilization and the time to mobilization were evaluated through regression and time-dependent survival analyses, respectively. The most common form of rehabilitation provided in pediatric critical care unit was physical therapy (45.5% patients) followed by occupational therapy (4.5%) and speech and language therapy (1.5%). Interventions were primarily nonmobility in nature (69.7% of sessions), most frequently in the form of chest physiotherapy (42.7% of sessions). The median time to mobilization was 2 days (interquartile range, 1-6) as compared with 1 day for nonmobility interventions (interquartile range, 1-3). Only 57 patients (9.5%) received early mobilization. Regression analyses revealed that increasing age, admission during winter, neuromuscular blockade, and sedative infusions were associated with an increased likelihood of receiving mobility therapy. Increasing age was a predictor of early mobilization, while neuromuscular blockade was associated with delayed mobilization. No significant differences in adverse events were found between nonmobility and mobility interventions., Conclusions: Only half of the children receive rehabilitation while in the pediatric critical care unit, and when it occurs, therapy is primarily focused on respiratory function. Mobilization appears to be reserved for at-risk children who were muscle relaxed and sedated; however, its implementation in these patients is delayed. Future pediatric-specific research is essential to identify patients at risk and to understand treatment priorities and rehabilitation strategies to improve functional recovery in critically ill children.
Published: 2014
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11. Shared Sensemaking and Clinical Decision-Making in Critical Care from a SA-Oriented Dashboard

Author: Boudreault, Lise, Jouvet, Philippe, Doyon-Poulin, Philippe, Tosi, Francesca, Editor-in-Chief, Germak, Claudio, Series Editor, Zurlo, Francesco, Series Editor, Jinyi, Zhi, Series Editor, Pozzatti Amadori, Marilaine, Series Editor, Caon, Maurizio, Series Editor, Melles, Marijke, editor, Albayrak, Armaĝan, editor, and Goossens, Richard H.M., editor
Published: 2024
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12. Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.

Author: Bembea, Melania, Agus, Michael, Akcan-Arikan, Ayse, Alexander, Peta, Basu, Rajit, Bennett, Tellen, Bohn, Desmond, Brandão, Leonardo, Brown, Ann-Marie, Carcillo, Joseph, Checchia, Paul, Cholette, Jill, Cheifetz, Ira, Cornell, Timothy, Doctor, Allan, Eckerle, Michelle, Erickson, Simon, Farris, Reid, Faustino, E, Fitzgerald, Julie, Fuhrman, Dana, Giuliano, John, Guilliams, Kristin, Gaies, Michael, Gorga, Stephen, Hall, Mark, Hanson, Sheila, Hartman, Mary, Hassinger, Amanda, Irving, Sharon, Jeffries, Howard, Jouvet, Philippe, Kannan, Sujatha, Karam, Oliver, Khemani, Robinder, Kissoon, Niranjan, Lacroix, Jacques, Laussen, Peter, Leclerc, Francis, Lee, Jan, Leteurtre, Stephane, Lobner, Katie, McKiernan, Patrick, Menon, Kusum, Monagle, Paul, Muszynski, Jennifer, Odetola, Folafoluwa, Parker, Robert, Pathan, Nazima, Pierce, Richard, Pineda, Jose, Prince, Jose, Robinson, Karen, Rowan, Courtney, Ryerson, Lindsay, Sanchez-Pinto, L, Schlapbach, Luregn, Selewski, David, Shekerdemian, Lara, Simon, Dennis, Smith, Lincoln, Squires, James, Squires, Robert, Sutherland, Scott, Ouellette, Yves, Spaeder, Michael, Srinivasan, Vijay, Steiner, Marie, Tasker, Robert, Thiagarajan, Ravi, Thomas, Neal, Tissieres, Pierre, Traube, Chani, Tucci, Marisa, Typpo, Katri, Wainwright, Mark, Ward, Shan, Watson, R, Weiss, Scott, Whitney, Jane, Willson, Doug, Wynn, James, Yehya, Nadir, and Zimmerman, Jerry
Subjects: Child, Critical Care, Critical Illness, Evidence-Based Medicine, Humans, Multiple Organ Failure, Organ Dysfunction Scores
Abstract: Prior criteria for organ dysfunction in critically ill children were based mainly on expert opinion. We convened the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) expert panel to summarize data characterizing single and multiple organ dysfunction and to derive contemporary criteria for pediatric organ dysfunction. The panel was composed of 88 members representing 47 institutions and 7 countries. We conducted systematic reviews of the literature to derive evidence-based criteria for single organ dysfunction for neurologic, cardiovascular, respiratory, gastrointestinal, acute liver, renal, hematologic, coagulation, endocrine, endothelial, and immune system dysfunction. We searched PubMed and Embase from January 1992 to January 2020. Study identification was accomplished using a combination of medical subject headings terms and keywords related to concepts of pediatric organ dysfunction. Electronic searches were performed by medical librarians. Studies were eligible for inclusion if the authors reported original data collected in critically ill children; evaluated performance characteristics of scoring tools or clinical assessments for organ dysfunction; and assessed a patient-centered, clinically meaningful outcome. Data were abstracted from each included study into an electronic data extraction form. Risk of bias was assessed using the Quality in Prognosis Studies tool. Consensus was achieved for a final set of 43 criteria for pediatric organ dysfunction through iterative voting and discussion. Although the PODIUM criteria for organ dysfunction were limited by available evidence and will require validation, they provide a contemporary foundation for researchers to identify and study single and multiple organ dysfunction in critically ill children.
Published: 2022

13. Antimicrobial treatment duration for uncomplicated bloodstream infections in critically ill children: a multicentre observational study

Author: Pong, Sandra, Fowler, Robert A., Murthy, Srinivas, Pernica, Jeffrey M., Gilfoyle, Elaine, Fontela, Patricia, Rishu, Asgar H., Mitsakakis, Nicholas, Hutchison, James S., Science, Michelle, Seto, Winnie, Jouvet, Philippe, and Daneman, Nick
Published: 2022
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14. Influence of implementing a protocol for an intravenously administered ammonia scavenger on the management of acute hyperammonemia in a pediatric intensive care unit

Author: Brossier, David, Goyer, Isabelle, Ziani, Lydia, Marquis, Christopher, Mitchell, Grant, Ozanne, Bruno, and Jouvet, Philippe
Published: 2018
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15. Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Author: Reyes, Luis Felipe, Murthy, Srinivas, Garcia-Gallo, Esteban, Merson, Laura, Ibáñez-Prada, Elsa, Rello, Jordi, Fuentes, Yuli, Martin-Loeches, Ignacio, Bozza, Fernando, Duque, Sara, Taccone, Fabio, Fowler, Robert, Kartsonaki, Christiana, Gonçalves, Bronner, Citarella, Barbara Wanjiru, Aryal, Diptesh, Burhan, Erlina, Cummings, Matthew, Delmas, Christelle, Diaz, Rodrigo, Figueiredo-Mello, Claudia, Hashmi, Madiha, Panda, Prasan Kumar, Jiménez, Miguel Pedrera, Rincon, Diego Fernando Bautista, Thomson, David, Nichol, Alistair, Marshall, John, Olliaro, Piero, Abbas, Ali, Abdukahil, Sheryl Ann, Abe, Ryuzo, Abel, Laurent, Absil, Lara, Acharya, Subhash, Acker, Andrew, Adrião, Diana, Al Ageel, Saleh, Ahmed, Shakeel, Ainscough, Kate, Aisa, Tharwat, Hssain, Ali Ait, Tamlihat, Younes Ait, Akimoto, Takako, Akmal, Ernita, Al Qasim, Eman, Alalqam, Razi, Al-Dabbous, Tala, Alegesan, Senthilkumar, Alegre, Cynthia, Alessi, Marta, Alex, Beatrice, Alexandre, Kévin, Al-Fares, Abdulrahman, Alfoudri, Huda, Ali, Imran, Shah, Naseem Ali, Alidjnou, Kazali Enagnon, Aliudin, Jeffrey, Alkhafajee, Qabas, Allavena, Clotilde, Allou, Nathalie, Altaf, Aneela, Alves, João, Alves, João Melo, Alves, Rita, Cabrita, Joana Alves, Amaral, Maria, Ampaw, Phoebe, Andini, Roberto, Andréjak, Claire, Angheben, Andrea, Angoulvant, François, Ansart, Séverine, Antonelli, Massimo, de Brito, Carlos Alexandre Antunes, Apriyana, Ardiyan, Arabi, Yaseen, Aragao, Irene, Araujo, Carolline, Arcadipane, Antonio, Archambault, Patrick, Arenz, Lukas, Arlet, Jean-Benoît, Arnold-Day, Christel, Arora, Lovkesh, Arora, Rakesh, Artaud-Macari, Elise, Asensio, Angel, Asif, Namra, Asim, Mohammad, Assie, Jean Baptiste, Atique, Anika, Attanyake, A., Auchabie, Johann, Aumaitre, Hugues, Auvet, Adrien, Azemar, Laurène, Azoulay, Cecile, Bach, Benjamin, Bachelet, Delphine, Badr, Claudine, Baig, Nadia, Baillie, J. Kenneth, Bak, Erica, Bakakos, Agamemnon, Bal, Andriy, Balan, Valeria, Bani-Sadr, Firouzé, Barbalho, Renata, Barclay, Wendy, Barnikel, Michaela, Barrasa, Helena, Barrelet, Audrey, Barrigoto, Cleide, Bartoli, Marie, Baruch, Joaquín, Basmaci, Romain, Battaglini, Denise, Bauer, Jules, Dow, Denisse Bazan, Beane, Abigail, Bedossa, Alexandra, Begum, Husna, Behilill, Sylvie, Beishuizen, Albertus, Beljantsev, Aleksandr, Bellemare, David, Beltrame, Anna, Beluze, Marine, Benech, Nicolas, Benkerrou, Dehbia, Bennett, Suzanne, Bento, Luís, Berdal, Jan-Erik, Bergeaud, Delphine, Bergin, Hazel, Sobrino, José Luis Bernal, Bertoli, Giulia, Bertolino, Lorenzo, Bessis, Simon, Bevilcaqua, Sybille, Bezulier, Karine, Bhatt, Amar, Bhavsar, Krishna, Bianco, Claudia, Singh, Moirangthem Bikram, Humaid, Felwa Bin, Bissuel, François, Bitker, Laurent, Bitton, Jonathan, Blanco-Schweizer, Pablo, Blier, Catherine, Bloos, Frank, Blot, Mathieu, Boccia, Filomena, Bodenes, Laetitia, Bogaert, Debby, Boivin, Anne-Hélène, Bolze, Pierre-Adrien, Bompart, François, Borges, Diogo, Borie, Raphaël, Bosse, Hans Martin, Botelho-Nevers, Elisabeth, Bouadma, Lila, Bouchaud, Olivier, Bouchez, Sabelline, Bouhmani, Dounia, Bouhour, Damien, Bouiller, Kévin, Bouillet, Laurence, Bouisse, Camile, Boureau, Anne-Sophie, Bourke, John, Bouscambert, Maude, Bousquet, Aurore, Bouziotis, Jason, Boxma, Bianca, Boyer-Besseyre, Marielle, Boylan, Maria, Braconnier, Axelle, Braga, Cynthia, Brandenburger, Timo, Monteiro, Filipa Brás, Brazzi, Luca, Breen, Dorothy, Breen, Patrick, Brickell, Kathy, Browne, Alex, Browne, Shaunagh, Brusse-Keizer, Marjolein, Buchtele, Nina, Buesaquillo, Christian, Bugaeva, Polina, Buisson, Marielle, Burrell, Aidan, Bustos, Ingrid, Butnaru, Denis, Cabie, André, Cabral, Susana, Caceres, Eder, Cadoz, Cyril, Garcês, Rui Caetano, Calligy, Kate, Calvache, Jose Andres, Camões, João, Campana, Valentine, Campbell, Paul, Canepa, Cecilia, Cantero, Mireia, Caraux-Paz, Pauline, Cárcel, Sheila, Cardellino, Chiara Simona, 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Silva, Catarina, Silva, Maria Joao, Silva, Rogério, Sin, Wai Ching, Singh, Budha Charan, Singh, Punam, Sitompul, Pompini Agustina, Skogen, Vegard, Smith, Sue, Smood, Benjamin, Smyth, Coilin, Smyth, Michelle, Snacken, Morgane, So, Dominic, Solomon, Joshua, Solomon, Tom, Somers, Emily, Sommet, Agnès, Song, Myung Jin, Song, Rima, Song, Tae, Chia, Jack Song, Sotto, Albert, Soum, Edouard, Sousa, Ana Chora, Sousa, Marta, Uva, Maria Sousa, Sperry, Alexandra, Spinuzza, Elisabetta, Darshana, B., Sriskandan, Shiranee, Stabler, Sarah, Staudinger, Thomas, Stecher, Stephanie-Susanne, Stienstra, Ymkje, Stiksrud, Birgitte, Stolz, Eva, Stone, Amy, Streinu-Cercel, Adrian, Streinu-Cercel, Anca, Stuart, Ami, Stuart, David, Suen, Gabriel, Suen, Jacky, Sultana, Asfia, Summers, Charlotte, Supic, Dubravka, Surovcová, Magdalena, Svistunov, Andrey, Syrigos, Konstantinos, Sztajnbok, Jaques, Szuldrzynski, Konstanty, Tabrizi, Shirin, Tagherset, Lysa, Taleb, Sara, Talsma, Jelmer, Tampubolon, Maria Lawrensia, Tanaka, Hiroyuki, Taqdees, Huda, Taqi, Arshad, Tardivon, Coralie, Tattevin, Pierre, Taufik, M. Azhari, Tawfik, Hassan, Tedder, Richard, Teixeira, João, Tejada, Sofia, Tellier, Marie-Capucine, Téoulé, François, Terpstra, Pleun, Terrier, Olivier, Terzi, Nicolas, Tessier-Grenier, Hubert, Tey, Adrian, Thakur, Anand, Thibault, Vincent, Thiberville, Simon-Djamel, Thill, Benoît, Thompson, Shaun, Thomson, Emma, Thwaites, Ryan, Tierney, Paul, Tieroshyn, Vadim, Timashev, Peter, Timsit, Jean-François, Tissot, Noémie, Toki, Maria, Tonby, Kristian, Torre, Marta, Torres, Antoni, Torres, Margarida, Torres-Zevallos, Hernando, Towers, Michael, Trapani, Tony, Treoux, Théo, Tromeur, Cécile, Trontzas, Ioannis, Trouillon, Tiffany, Truong, Jeanne, Tual, Christelle, Tubiana, Sarah, Tuite, Helen, Turmel, Jean-Marie, Turtle, Lance, Twardowski, Pawel, Uchiyama, Makoto, Udayanga, P., Udy, Andrew, Ullrich, Roman, Uribe, Alberto, Usman, Asad, Uyeki, Timothy, Vajdovics, Cristinava, Val-Flores, Luís, Valran, Amélie, van de Velde, Stijn, van den Berge, Marcel, van der Palen, Job, van der Valk, Paul, van der Vekens, Nicky, van der Voort, Peter, van der Werf, Sylvie, van Gulik, Laura, van Hattem, Jarne, van Netten, Carolien, van Veen, Ilonka, Vanel, Noémie, Vanoverschelde, Henk, Varghese, Pooja, Vauchy, Charline, Veislinger, Aurélie, Vencken, Sebastian, Ventura, Sara, Verbon, Annelies, Vickers, James, Vidal, José Ernesto, Vieira, César, Vijayan, Deepak, Villanueva, Joy Ann, Villar, Judit, Villeneuve, Pierre-Marc, Villoldo, Andrea, Visseaux, Benoit, Visser, Hannah, Vitiello, Chiara, Vonkeman, Harald, Vuotto, Fanny, Shukeri, Wan Fadzlina Wan Muhd, Wang, Chih-Hsien, Webb, Steve, Wei, Jia, Weil, Katharina, Wesselius, Sanne, West, T. Eoin, Wham, Murray, Whelan, Bryan, White, Nicole, Wicky, Paul Henri, Wiedemann, Aurélie, Wijaya, Surya Otto, Wille, Keith, Willems, Suzette, Williams, Virginie, Wils, Evert-Jan, Yiu, Ng Wing, Wong, Calvin, Xynogalas, Ioannis, Yamazaki, Masaki, Yazdanpanah, Yazdan, Yelnik, Cécile, Yerkovich, Stephanie, Yokoyama, Toshiki, Yonis, Hodane, Yousif, Obada, Yuliarto, Saptadi, Zaaqoq, Akram, Zabbe, Marion, Zahran, Maram, Zambon, Maria, Zanella, Alberto, Zayyad, Hiba, Zoufaly, Alexander, Zucman, David, University of Oxford, University of La Sabana = Universitad de la Sabana, ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], Institut Pasteur [Paris] (IP), Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), This work was supported by the UK Foreign, Commonwealth, and Development Office and Wellcome [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135], CIHR Coronavirus Rapid Research Funding Opportunity OV2170359, Grants from Rapid European COVID-19 Emergency Response research (RECOVER) [H2020 Project 101003589] and European Clinical Research Alliance on Infectious Diseases (ECRAID) [965313], The Imperial NIHR Biomedical Research Centre, The Cambridge NIHR Biomedical Research Centre, and Endorsed by the Irish Critical Care-Clinical Trials Group, co-ordinated in Ireland by the Irish Critical Care-Clinical Trials Network at University College Dublin and funded by the Health Research Board of Ireland [CTN-2014-12]. This work uses Data/Materials provided by patients and collected by the NHS as part of their care and support #DataSavesLives. The Data/materials used for this research were obtained from ISARIC4C. The COVID-19 Clinical Information Network (CO-CIN) data was collated by ISARIC4C Investigators. Data and Material provision were supported by grants from: the National Institute for Health Research (NIHR, award CO-CIN-01), the Medical Research Council (MRC, Grant MC_PC_19059), and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with Public Health England (PHE), (Award 200907), Wellcome Trust [Turtle, Lance-fellowship 205228/Z/16/Z], NIHR HPRU in Respiratory Infections at Imperial College London with PHE (Award 200927), Liverpool Experimental Cancer Medicine Centre (Grant C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (Award IS-BRC-1215-20013), and NIHR Clinical Research Network providing infrastructure support. This work was possible due to the dedication and hard work of the Norwegian SARS-CoV-2 study team and supported by grants from Research Council of Norway Grant No. 312780 and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner, The dedication and hard work of the Groote Schuur Hospital Covid ICU Team, and supported by the Groote Schuur nursing and University of Cape Town registrar bodies coordinated by the Division of Critical Care at the University of Cape Town, and supported by the COVID clinical management team, AIIMS, Rishikesh, India., European Project: 101003589, H2020-SC1-PHE-CORONAVIRUS-2020,RECOVER(2020), Reyes, Luis Felipe, Murthy, Sriniva, Garcia-Gallo, Esteban, Merson, Laura, Ibáñez-Prada, Elsa D., Rello, Jordi, Fuentes, Yuli V., Martin-Loeches, Ignacio, Bozza, Fernando, Duque, Sara, Taccone, Fabio S., Fowler, Robert A., Kartsonaki, Christiana, Gonçalves, Bronner P., Citarella, Barbara Wanjiru, Aryal, Diptesh, Burhan, Erlina, Cummings, Matthew J., Delmas, Christelle, Diaz, Rodrigo, Figueiredo-Mello, Claudia, Hashmi, Madiha, Panda, Prasan Kumar, Jiménez, Miguel Pedrera, Rincon, Diego Fernando Bautista, Thomson, David, Nichol, Alistair, Marshall, John C., Olliaro, Piero L., Abbas, Ali, Abdukahil, Sheryl Ann, Abe, Ryuzo, Abel, Laurent, Absil, Lara, Acharya, Subhash, Acker, Andrew, Adrião, Diana, Al Ageel, Saleh, Ahmed, Shakeel, Ainscough, Kate, Aisa, Tharwat, Hssain, Ali Ait, Tamlihat, Younes Ait, Akimoto, Takako, Akmal, Ernita, Al Qasim, Eman, Alalqam, Razi, Al-dabbous, Tala, Alegesan, Senthilkumar, Alegre, Cynthia, Alessi, Marta, Alex, Beatrice, Alexandre, Kévin, Al-Fares, Abdulrahman, Alfoudri, Huda, Ali, Imran, Shah, Naseem Ali, Alidjnou, Kazali Enagnon, Aliudin, Jeffrey, Alkhafajee, Qaba, Allavena, Clotilde, Allou, Nathalie, Altaf, Aneela, Alves, João, Alves, João Melo, Alves, Rita, Cabrita, Joana Alve, Amaral, Maria, Ampaw, Phoebe, Andini, Roberto, Andréjak, Claire, Angheben, Andrea, Angoulvant, Françoi, Ansart, Séverine, Antonelli, Massimo, de Brito, Carlos Alexandre Antune, Apriyana, Ardiyan, Arabi, Yaseen, Aragao, Irene, Araujo, Carolline, Arcadipane, Antonio, Archambault, Patrick, Arenz, Luka, Arlet, Jean-Benoît, Arnold-Day, Christel, Arora, Lovkesh, Arora, Rakesh, Artaud-Macari, Elise, Asensio, Angel, Asif, Namra, Asim, Mohammad, Assie, Jean Baptiste, Atique, Anika, Attanyake, A. 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Dankwa, Emmanuelle A., Dantas, Jorge, D’Aragon, Frédérick, de Loughry, Gillian, de Mendoza, Diego, De Montmollin, Etienne, de Oliveira França, Rafael Freita, de Pinho Oliveira, Ana Isabel, De Rosa, Rosanna, de Silva, Thushan, de Vries, Peter, Deacon, Jillian, Dean, David, Debard, Alexa, Debray, Marie-Pierre, DeCastro, Nathalie, Dechert, William, Deconninck, Lauren, Decours, Romain, Defous, Eve, Delacroix, Isabelle, Delaveuve, Eric, Delavigne, Karen, Dell’Amore, Andrea, Delobel, Pierre, Delsing, Corine, Demonchy, Elisa, Denis, Emmanuelle, Deplanque, Dominique, Depuydt, Pieter, Descamps, Diane, Desvallées, Mathilde, Dewayanti, Santi, Dhanger, Pathik, Diallo, Alpha, Diamantis, Sylvain, Dias, André, Diaz, Juan Jose, Diaz, Priscila, Didier, Kévin, Diehl, Jean-Luc, Dieperink, Wim, Dimet, Jérôme, Dinot, Vincent, Diop, Fara, Diouf, Alphonsine, Dishon, Yael, Djossou, Félix, Docherty, Annemarie B., Doherty, Helen, Dondorp, Arjen M., Donnelly, Christl A., Donnelly, Maria, Donohue, Chloe, Donohue, 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P. Sanka Ruwan Sri, Sriskandan, Shiranee, Stabler, Sarah, Staudinger, Thoma, Stecher, Stephanie-Susanne, Stienstra, Ymkje, Stiksrud, Birgitte, Stolz, Eva, Stone, Amy, Streinu-Cercel, Adrian, Streinu-Cercel, Anca, Stuart, Ami, Stuart, David, Suen, Gabriel, Suen, Jacky Y., Sultana, Asfia, Summers, Charlotte, Supic, Dubravka, Surovcová, Magdalena, Svistunov, Andrey, Syrigos, Konstantino, Sztajnbok, Jaque, Szuldrzynski, Konstanty, Tabrizi, Shirin, Tagherset, Lysa, Taleb, Sara, Talsma, Jelmer, Tampubolon, Maria Lawrensia, Tanaka, Hiroyuki, Taqdees, Huda, Taqi, Arshad, Tardivon, Coralie, Tattevin, Pierre, Taufik, M. Azhari, Tawfik, Hassan, Tedder, Richard S., Teixeira, João, Tejada, Sofia, Tellier, Marie-Capucine, Téoulé, Françoi, Terpstra, Pleun, Terrier, Olivier, Terzi, Nicola, Tessier-Grenier, Hubert, Tey, Adrian, Thakur, Anand, Thibault, Vincent, Thiberville, Simon-Djamel, Thill, Benoît, Thompson, Shaun, Thomson, Emma C., Thwaites, Ryan S., Tierney, Paul, Tieroshyn, Vadim, Timashev, Peter S., Timsit, Jean-Françoi, Tissot, Noémie, Toki, Maria, Tonby, Kristian, Torre, Marta, Torres, Antoni, Torres, Margarida, Torres-Zevallos, Hernando, Towers, Michael, Trapani, Tony, Treoux, Théo, Tromeur, Cécile, Trontzas, Ioanni, Trouillon, Tiffany, Truong, Jeanne, Tual, Christelle, Tubiana, Sarah, Tuite, Helen, Turmel, Jean-Marie, Turtle, Lance C. W., Twardowski, Pawel, Uchiyama, Makoto, Udayanga, P. G. Ishara, Udy, Andrew, Ullrich, Roman, Uribe, Alberto, Usman, Asad, Uyeki, Timothy M., Vajdovics, Cristinava, Val-Flores, Luí, Valran, Amélie, Van de Velde, Stijn, van den Berge, Marcel, van der Palen, Job, van der Valk, Paul, Van Der Vekens, Nicky, Van der Voort, Peter, Van Der Werf, Sylvie, van Gulik, Laura, Van Hattem, Jarne, van Netten, Carolien, van Veen, Ilonka, Vanel, Noémie, Vanoverschelde, Henk, Varghese, Pooja, Vauchy, Charline, Veislinger, Aurélie, Vencken, Sebastian, Ventura, Sara, Verbon, Annelie, Vickers, Jame, Vidal, José Ernesto, Vieira, César, Vijayan, Deepak, Villanueva, Joy Ann, Villar, Judit, Villeneuve, Pierre-Marc, Villoldo, Andrea, Visseaux, Benoit, Visser, Hannah, Vitiello, Chiara, Vonkeman, Harald, Vuotto, Fanny, Shukeri, Wan Fadzlina Wan Muhd, Wang, Chih-Hsien, Webb, Steve, Wei, Jia, Weil, Katharina, Wesselius, Sanne, West, T. Eoin, Wham, Murray, Whelan, Bryan, White, Nicole, Wicky, Paul Henri, Wiedemann, Aurélie, Wijaya, Surya Otto, Wille, Keith, Willems, Suzette, Williams, Virginie, Wils, Evert-Jan, Yiu, Ng Wing, Wong, Calvin, Xynogalas, Ioanni, Yamazaki, Masaki, Yazdanpanah, Yazdan, Yelnik, Cécile, Yerkovich, Stephanie, Yokoyama, Toshiki, Yonis, Hodane, Yousif, Obada, Yuliarto, Saptadi, Zaaqoq, Akram, Zabbe, Marion, Zahran, Maram, Zambon, Maria, Zanella, Alberto, Zayyad, Hiba, Zoufaly, Alexander, Zucman, David, Group, ISARIC Characterization, Intensive Care Medicine, AII - Amsterdam institute for Infection and Immunity, Medical Microbiology and Infection Prevention, AII - Inflammatory diseases, Ibáñez-Prada, Elsa D, Fuentes, Yuli V, Taccone, Fabio S, Fowler, Robert A, Gonçalves, Bronner P, Cummings, Matthew J, Marshall, John C, Olliaro, Piero L, Institut Català de la Salut, [Reyes LF] Pandemic Sciences Institute, University of Oxford, Oxford, UK. Infectious Diseases Department, Universidad de La Sabana, Chía, Colombia. Critical Care Department, Clínica Universidad de La Sabana, Chía, Colombia. [Murthy S] Department of Pediatrics, University of British Columbia, Vancouver, Canada. [Garcia-Gallo E] Infectious Diseases Department, Universidad de La Sabana, Chía, Colombia. [Merson L] Pandemic Sciences Institute, University of Oxford, Oxford, UK. [Ibáñez-Prada ED] Infectious Diseases Department, Universidad de La Sabana, Chía, Colombia. Critical Care Department, Clínica Universidad de La Sabana, Chía, Colombia. [Rello J] Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia (CRIPS), Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: enfermedades respiratorias::trastornos respiratorios::insuficiencia respiratoria [ENFERMEDADES], COVID-19, Critical care, High flow nasal cannula, Invasive mechanical ventilation, Respiració artificial, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, COVID-19 (Malaltia) - Tractament, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Prospective Studies, SARS-CoV-2, Tachypnea, Respiratory Insufficiency, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Otros calificadores::/terapia [Otros calificadores], Insuficiència respiratòria - Tractament, Therapeutics::Therapeutics::Respiratory Therapy::Respiration, Artificial::Noninvasive Ventilation [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Other subheadings::/therapy [Other subheadings], terapéutica::terapéutica::terapia respiratoria::respiración artificial::ventilación no invasiva [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Respiratory Tract Diseases::Respiration Disorders::Respiratory Insufficiency [DISEASES], Prospective Studie, Human
Abstract: Invasive mechanical ventilation; COVID-19; Critical care Ventilación mecánica invasiva; COVID-19; Cuidado crítico Ventilació mecànica invasiva; COVID-19; Atenció crítica Background Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. This work was supported by the UK Foreign, Commonwealth, and Development Office and Wellcome [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135]; CIHR Coronavirus Rapid Research Funding Opportunity OV2170359; Grants from Rapid European COVID-19 Emergency Response research (RECOVER) [H2020 Project 101003589] and European Clinical Research Alliance on Infectious Diseases (ECRAID) [965313]; The Imperial NIHR Biomedical Research Centre; The Cambridge NIHR Biomedical Research Centre; and Endorsed by the Irish Critical Care-Clinical Trials Group, co-ordinated in Ireland by the Irish Critical Care-Clinical Trials Network at University College Dublin and funded by the Health Research Board of Ireland [CTN-2014-12]. This work uses Data/Materials provided by patients and collected by the NHS as part of their care and support #DataSavesLives. The Data/materials used for this research were obtained from ISARIC4C. The COVID-19 Clinical Information Network (CO-CIN) data was collated by ISARIC4C Investigators. Data and Material provision were supported by grants from: the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; Grant MC_PC_19059), and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with Public Health England (PHE), (Award 200907), Wellcome Trust [Turtle, Lance-fellowship 205228/Z/16/Z], NIHR HPRU in Respiratory Infections at Imperial College London with PHE (Award 200927), Liverpool Experimental Cancer Medicine Centre (Grant C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (Award IS-BRC-1215-20013), and NIHR Clinical Research Network providing infrastructure support. This work was possible due to the dedication and hard work of the Norwegian SARS-CoV-2 study team and supported by grants from Research Council of Norway Grant No. 312780 and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner; The dedication and hard work of the Groote Schuur Hospital Covid ICU Team, and supported by the Groote Schuur nursing and University of Cape Town registrar bodies coordinated by the Division of Critical Care at the University of Cape Town; and supported by the COVID clinical management team, AIIMS, Rishikesh, India.
Published: 2022
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16. Acceptable respiratory physiologic limits for children during weaning from mechanical ventilation

Author: Santschi, Miriam, Gauvin, France, Hatzakis, Georges, Lacroix, Jacques, and Jouvet, Philippe
Published: 2007
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17. Using research to prepare for outbreaks of severe acute respiratory infection

Author: Mich, Vann, Pho, Yaty, Bory, Sotharith, Vann, Mich, Teav, Bunlor, Som, Leakhann, Jarrvisalo, Mikko J, Pulkkinen, Anni, Kuitunen, Anne, Ala-kokko, Tero, Melto, Sari, Daix, Thomas, Philippart, Francois, Antoine, Marchalot, Tiercelet, Kelly, Bruel, Cedric, Nicholas, Sedillot, Siami, Shidasp, Fabienne, Taimon, Bruyere, Raomi, Forceville, Xavier, Erickson, Simon, Campbell, Lewis, Sonawane, Ravikiran, Santamaria, John, Kol, Mark, Awasthi, Shally, Powis, Jeff, Hall, Richard, McCarthy, Anne E, Jouvet, Philippe, Opaysky, Mary Anne, Gilfoyle, Elaine, Farshait, Nataly, Martin, Dori-Ann, Griesdale, Donald, Katz, Kevin, Ruberto, Aaron J, Carrier, Francois Martin, Lamontagne, Francois, Muscedere, John, Rishu, Asgar, Sin, Wai Ching, Ngai, Wallace Chun Wai, Young, Paul, Forrest, Annette, Kazemi, Alex, Henderson, Seton, Browne, Troy, Ganeshalingham, Anusha, McConnochie, Rachael, Cho, Jae Hwa, Park, Tai Sun, Sim, Yun Su, Chang, Youjin, Lee, Heung Bum, Park, Seung Yong, Chan, Wai Ming, Lee, Won-Yeon, Wallace, David J, Angus, Derek C, Charles, Anthony G, van Doom, H Rogier, Kinh, Nguyen Van, Trung, Nguyen Vu, Prin, Meghan, Twagirumugabe, Theogene, Umuhire, Olivier Felix, Sylvain, Habarurema, Al Qasim, Eman, Heraud, Jean-Michel, Raberahona, Mihaja, Rabarison, Joelinotahiana Hasina, Patrigeon, Santiago Perez, Ramirez-Venegas, Alejandra, Melendez, Javier Araujo, Guerrero, M Lourdes, Mambule, Ivan, Ochieng, Otieno George, Nadjm, Behzad, Li, Iris Wai Sum, Choi, Won-Il, Florence, Komurian-Pradel, Arabi, Yaseen M, West, T Eoin, Riviello, Elisabeth D, Parke, Rachael, Djillali, Annane E, Fowler, Robert, Murthy, Srinivas, Nichol, Alistair, Cheng, Allen C, Semple, Calum, George, Maya, Valkonen, Miia, McArthur, Colin, Carson, Gail, O'Neill, Genevieve, Cobb, J Perren, Dunning, Jake, Chiche, Jean-Daniel, Huh, Jin-Won, Marshall, John, Rello, Jordi, Guillebaud, Julia, Razanazatovo, Norosoa, Otieno, Juilett Wambura, Green, Karen, Rowan, Kathy, Baillie, John Kenneth, Merson, Laura, Hsu, Li Yang, Christian, Michael D, Egi, Moritoki, Shindo, Nahoko, Horby, Peter, Pardinaz-Solis, Raul, Ubiergo, Sebastian Ugarte, Webb, Steve AR, Uyeki, Timothy M, Gordon, Anthony C, Paterson, David L, Everett, Dean, Giamarellos-Bourboulis, Evangelos J, Longuere, Kajsa-Stina, Maslove, David, Ohuma, Eric, Growl, Gloria, PedutemHumber, Theresa, EllazarHumber, Edward, Bahinskaya, Ilona, Osbourne-Townsend, Joan, Bentley, Andrew, Goodson, Jennifer, Welters, Ingeborg, Malik, Nadia, Browne, TS, Mahesh, Vinaya, Investigators, SPRINT-SARI, HUS Perioperative, Intensive Care and Pain Medicine, University of Helsinki, Anestesiologian yksikkö, University College Dublin [Dublin] (UCD), Monash University [Melbourne], We acknowledge support from the National Health and Medical Research Council in Australia, the Australia New Zealand Intensive Care Society Clinical Trials Group and the Seventh Framework Program in Europe, which have facilitated the progress that has been made for central project infrastructure. Data collection was funded locally by local research coordinators and investigators, including the International Respiratory and Severe Illness Center, University of Washington., Collaborators Vann Mich, Khmer Soviet Friend Hospital. Yaty Pho, Khmer Soviet Friend Hospital. Sotharith Bory, Calmette Hospital and University of Health Sciences. Mich Vann, Khmer-Soviet Friendship Hospital and University of Health Sciences. Bunlor Teav, Takeo Provincial Hospital. Leakhann Som, National Pediatric Hospital. Mikko J Jarrvisalo, Turku university hospital, ICU. Anni Pulkkinen, Central Hospital of Central Finland. Anne Kuitunen, Tampere University Hospital. Tero Ala-kokko, Oulu University Hospital, Research Group of Anesthesiology, Surgery and Intensive Care Medicine. Sari. Melto, South Karelia Central Hospital. Thomas DAIX, Reanimation polyvalente, CHU Dupuytren, Limoges, France and Inserm CIC 1435, CHU Dupuytren, Limoges, France. Francois Philippart, Intensive Care Unit. Marchalot Antoine, Dieppe General Hospital. Kelly Tiercelet, Groupe hospitalier Paris Saint Joseph. Cedric Bruel, Groupe hospitalier Paris Saint Joseph. BRUYERE Remi, Centre Hospitalier Fleyriat. Sedillot Nicholas, Centre Hospitalier Fleyriat. Shidasp SIAMI, General Intensive Care Medicine, Sud Essonne Hospital Etampes. Marchalot Antoine, Centre Hospitalier Dieppe. Taimon Fabienne, Service de Medecine Intensive et Reanimation, Rouen University Hospital (G.B.), and Normandie University, Universite de Rouen, U1096, Rouen University Hospital. Philippart, Groupe hospitalier Paris Saint joseph. Raomi Bruyere, Service de reanimation. Centre Hospitalier Fleyriat. Xavier Forceville, Grand Hopital de l'Est Francilien. Simon Erickson, Perth Children's Hospital. Lewis Campbell, Royal Darwin Hospital. Ravikiran Sonawane, Rockingham General Hospital. John Santamaria, St Vincent's Hospital (Melbourne). Mark Kol, Concord Hospital. Shally Awasthi, King George's Medical University. Jeff Powis, Michael Garron Hospital. Richard Hall, Dalhousie University. Anne E McCarthy, University of Ottawa and the Ottawa Hospital. Philippe Jouvet, Ste-Justine Hospital and Research Center. Mary Anne Opavsky, Joseph Brant Hospital. Elaine Gilfoyle, University of Calgary. Nataly Farshait, Humber River Hospital. Dori-Ann Martin, University of Calgary. Donald Griesdale, Department of Anesthesiology, Pharmacology & Therapeutics Department of Medicine, Divisions of Critical Care Medicine & Neurology University of British Columbia. Kevin Katz, North York General Hospital. Aaron J. Ruberto, Queen's University & Kingston Health Sciences Centre. Francois Martin Carrier, Centre Hospitalier de l'Universite de Montreal. Francois Lamontagne, Universite de Sherbrooke. John Muscedere, Queens University. Asgar Rishu, Sunnybrook Health Sciences Centre. Wai Ching Sin, Department of Adult Intensive Care Unit, Queen Mary Hospital. Wallace Chun Wai Ngai, Department of Adult Intensive Care Unit, Queen Mary Hospital. Paul Young, Medical Research Institute of New Zealand. Dr Annette Forrest, Waikato Hospital. Alex Kazemi, Middlemore Hospital. Seton Henderson, Christchurch Hospital. Troy Browne, Tauranga Hospital. Anusha Ganeshalingham, Starship Hospital. Rachael McConnochie, Department of Critical Care Medicine, Auckland City Hospital. Jae Hwa Cho, Yonsei University. Tai Sun Park, Hanyang University Guri Hospital. Yun Su Sim, Hallym University Kangnam Sacred Hospital. Youjin Chang, Inje University, College of Medicine, Sanggye Paik Hospital. Heung Bum Lee, Chonbuk National University Hospital. Seung Yong Park, Chonbuk National University Hospital. Wai Ming Chan, Department of Adult Intensive Care Unit, Queen Mary Hospital, Hong Kong. Won-Yeon Lee, Yonsei University Wonju College of Medicine. David J. Wallace, University of Pittsburgh School of Medicine. Derek C. Angus, University of Pittsburgh School of Medicine. Anthony G Charles, University of North Carolina at Chapel Hill. H Rogier van Doorn, Oxford University Clinical Research Unit. Nguyen Van Kinh, National Hospital for Tropical Diseases. Nguyen Vu Trung, National Hospital for Tropical Diseases. Meghan Prin, Columbia University College of Physicians & Surgeons. Theogene Twagirumugabe, University of Rwanda /College of Medicine and Health Sciences. Olivier Felix Umuhire, Department of Anesthesia, Emergency Medicine and Critical Care. University of Rwanda. Habarurema Sylvain, Centre hospitalier Universitaire de Butare(CHUB). Eman Al Qasim, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center. Jean-Michel Heraud, Institut Pasteur de Madagascar. Mihaja Raberahona, University Hospital Joseph Raseta Befelatanana. Joelinotahiana Hasina Rabarison, Insttut Pasteur de Madagascar. Santiago Perez Patrigeon, Instituto Nacional de Ciencias Medicas y NutriciÃ³n Salvador SubirÃ¡n. Alejandra Ramirez-Venegas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas. Javier Araujo Meléndez, Hospital Central 'Dr. Ignacio Morones Prieto'. M. Lourdes Guerrero, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiren. Ivan Mambule, Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health University of Liverpool and Malawi-Liverpool-Wellcome Trust, Clinical Research Programme. Otieno George Ochieng, Kijabe Mission Hospital. Behzad Nadjm, Imperial College Healthcare NHS Trust, GBR. Iris Wai Sum Li, Queen Mary Hospital, School of Public Health, the University of Hong Kong. Won-Il Choi, Department of Medicine, Keimyung University, Dongsan Hospital. Komurian-Pradel Florence, Fondation Merieux. Yaseen M Arabi, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City. T. Eoin West, University of Washington. Elisabeth D Riviello, Harvard Medical School and Beth Israel Deaconess Medical Center. Rachael Parke, Cardiothoracic and Vascular ICU, Auckland City Hospital. AnnaneE Djillali, Raymond Poincare Hospital (APHP) Unievrsity of Versailles SQY/University Paris Saclay. Robert Fowler, Interdepartmental Division of Critical Care Medicine, University of Toronto. Srinivas Murthy, Department of Pediatrics. Alistair Nichol, University College Dublin / Monash University. Allen C Cheng, School of Public Health and Preventive Medicine, Monash University. Calum Semple, University of Liverpool. Maya George, Australian and New Zealand Intensive Care Research Centre, Monash University. Miia Valkonen, University of Helsinki and Helsinki University Hospital. Colin McArthur, Auckland City Hospital (DCCM 82). Gail Carson, University of Oxford. Genevieve O'Neill, Australian and New Zealand Intensive Care Research Centre, Monash University. J. Perren Cobb, University of Southern California. Jake Dunning, University of Oxford, Imperial College London. Jean-Daniel Chiche, Hopitaux Universitaire Paris Centre, site Cochin. Jin-Won Huh, ASAN Medical Center. John Marshall, St. Michael's Hospital. Jordi Rello, Ciberes & Vall d'Hebron University Hospital, Barcelona, Spain. Julia Guillebaud, Institut Pasteur de Madagascar. Norosoa Razanazatovo, Institut Pasteur de Madagascar. Juilett Wambura Otieno, KEMRI-Wellcome Trust Research Programme. Karen Green, Toronto Invasive Bacterial Diseases Network. Kathy Rowan, Intensive Care National Audit and Research Centre. John Kenneth Baillie, Roslin Institute, University of Edinburgh. Laura Merson, Infectious Diseases Data Observatory, Oxford, UK, Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, Oxford University, Oxford UK. Li Yang Hsu, National University of Singapore. Michael D. Christian, Essex & Herts Air Ambulance Trust. Miia Valkonen, Helsinki University Central Hospital. Moritoki Egi, Kobe University Hospital. Nahoko Shindo, World Health Organization. Peter Horby, University of Oxford. Raul Pardinaz-Solis, Nuffield Department of Medicine, University of Oxford. Sebastián Ugarte Ubiergo, Universidad Andrés Bello. Steve AR Webb, Monash University. Timothy M. Uyeki, Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia USA. Anthony C Gordon, Imperial College London. David L Paterson, University of Queensland Centre. Dean Everett, University of Edinburgh, The Queens Medical Research Institute and Malawi-Liverpool-Wellcome Trust, Clinical Research Programme. Evangelos J. Giamarellos-Bourboulis, National and Kapodistrian University of Athens, Medical School. Kajsa-Stina Longuere, University of Oxford. David Maslove, Queens University. Eric Ohuma, Oxford University. Gloria Crowl, Michael Garron Hospital. Theresa PedutemHumber, River Hospital. Edward EllazarHumber, River Hospital. Ilona Bahinskaya, University Health Network TGH MOT. Joan Osbourne-Townsend, Humber River Hospital. Andrew Bentley, University of Manchester. Ingeborg Welters, University of Liverpool. Nadia Malik, MountSinai Hospital/ William Osler Health Centre. Dr T S Browne, Tauranga Hospital. Jennifer Goodson, Tauranga Hospital. Vinaya Mahesh, North York General Hospital., and Carson, G
Subjects: medicine.medical_specialty, INTENSIVE-CARE-UNIT, global health, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intensive care, Case fatality rate, Epidemiology, Global health, medicine, pneumonia, 030212 general & internal medicine, Public, Environmental & Occupational Health, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Practice, OUTCOMES, Science & Technology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Outbreak, 030208 emergency & critical care medicine, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, 3126 Surgery, anesthesiology, intensive care, radiology, Intensive care unit, 3. Good health, critical care, REAL-TIME SURVEILLANCE, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Observational study, SOFA score, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, SPRINT-SARI investigators, business, influenza, Life Sciences & Biomedicine, Demography, outbreak preparedness
Abstract: International audience; Severe acute respiratory infections (SARI) remain one of the leading causes of mortality around the world in all age groups. There is large global variation in epidemiology, clinical management and outcomes, including mortality. We performed a short period observational data collection in critical care units distributed globally during regional peak SARI seasons from 1 January 2016 until 31 August 2017, using standardised data collection tools. Data were collected for 1 week on all admitted patients who met the inclusion criteria for SARI, with follow-up to hospital discharge. Proportions of patients across regions were compared for microbiology, management strategies and outcomes. Regions were divided geographically and economically according to World Bank definitions. Data were collected for 682 patients from 95 hospitals and 23 countries. The overall mortality was 9.5%. Of the patients, 21.7% were children, with case fatality proportions of 1% for those less than 5 years. The highest mortality was in those above 60 years, at 18.6%. Case fatality varied by region: East Asia and Pacific 10.2% (21 of 206), Sub-Saharan Africa 4.3% (8 of 188), South Asia 0% (0 of 35), North America 13.6% (25 of 184), and Europe and Central Asia 14.3% (9 of 63). Mortality in low-income and low-middle-income countries combined was 4% as compared with 14% in high-income countries. Organ dysfunction scores calculated on presentation in 560 patients where full data were available revealed Sequential Organ Failure Assessment (SOFA) scores on presentation were significantly associated with mortality and hospital length of stay. Patients in East Asia and Pacific (48%) and North America (24%) had the highest SOFA scores of >12. Multivariable analysis demonstrated that initial SOFA score and age were independent predictors of hospital survival. There was variability across regions and income groupings for the critical care management and outcomes of SARI. Intensive care unit-specific factors, geography and management features were less reliable than baseline severity for predicting ultimate outcome. These findings may help in planning future outbreak severity assessments, but more globally representative data are required.
Published: 2019

18. Validation process of a high‐resolution database in a paediatric intensive care unit—Describing the perpetual patient's validation.

Author: Mathieu, Audrey, Sauthier, Michael, Jouvet, Philippe, Emeriaud, Guillaume, and Brossier, David
Subjects: INTENSIVE care units, DATABASES, DATA quality, RESEARCH methodology, VITAL signs, PEDIATRICS, DATABASE management, LONGITUDINAL method, VIDEO recording
Abstract: Rationale: High data quality is essential to ensure the validity of clinical and research inferences based on it. However, these data quality assessments are often missing even though these data are used in daily practice and research. Aims and objectives: Our objective was to evaluate the data quality of our high‐resolution electronic database (HRDB) implemented in our paediatric intensive care unit (PICU). Methods We conducted a prospective validation study of a HRDB in a 32‐bed paediatric medical, surgical, and cardiac PICU in a tertiary care freestanding maternal‐child health centre in Canada. All patients admitted to the PICU with at least one vital sign monitored using a cardiorespiratory monitor connected to the central monitoring station. Results: Between June 2017 and August 2018, data from 295 patient days were recorded from medical devices and 4645 data points were video recorded and compared to the corresponding data collected in the HRDB. Statistical analysis showed an excellent overall correlation (R2 = 1), accuracy (100%), agreement (bias = 0, limits of agreement = 0), completeness (2% missing data), and reliability (ICC = 1) between recorded and collected data within clinically significant pre‐defined limits of agreement. Divergent points could all be explained. Conclusions: This prospective validation of a representative sample showed an excellent overall data quality. [ABSTRACT FROM AUTHOR]
Published: 2021
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19. The implementation of a synchronous telemedicine platform linking off-site pediatric intensivists and on-site fellows in a pediatric intensive care unit: A feasibility study.

Author: Nadar, Mahmoud, Jouvet, Philippe, Tucci, Marisa, Toledano, Baruch, Cyr, Martin, and Sicotte, Claude
Abstract: Objective: The aim of this study was to assess the feasibility of implementing a synchronous telemedicine platform in a pediatric intensive care unit (STEP-PICU).Method: A prospective mixed study was conducted. Two sources of data were mobilised: a survey with structured questionnaires and direct non-intrusive observation. The study site was the PICU of a university hospital. Users' perceptions of six aspects of the STEP-PICU were studied: telemedicine system quality, data quality, quality of technical support, use of the new system, overall satisfaction and system benefits.Results: During the 6-month experimentation period, use of the telemedicine platform was rather limited and fell short of the promoter's expectations.The mean scores for the six user perception dimensions were low, with no differences between the two groups of users. A Mann-Whitney test showed that being an off-site pediatric intensivist or on-site fellow did not make a statistically significant difference in responses on system quality (p = .518), data quality (p = 1.00), quality of technical support (p = 1.00), system use (p = .556), overall satisfaction (p = .482), or benefits (p = .365). The low use of the STEP-PICU was attributed to three root causes: human factors, the platform's functionalities, and technical problems.Discussion: The synchronous telemedicine service for PICU was feasible but would need good pre-implementation preparation to be truly helpful. Its usefulness during the night shift and holiday on-call periods was scored as low by the off-site pediatric intensivists and the on-site fellows. It would appear that such a service could be more beneficial for communications with other remote healthcare facilities, where there is a greater need for the expertise of a pediatric critical care intensivist. [ABSTRACT FROM AUTHOR]
Published: 2019
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20. Influence of implementing a protocol for an intravenously administered ammonia scavenger on the management of acute hyperammonemia in a pediatric intensive care unit.

Author: Brossier, David, Goyer, Isabelle, Ziani, Lydia, Marquis, Christopher, Mitchell, Grant, Ozanne, Bruno, and Jouvet, Philippe
Abstract: The purpose of the study was to evaluate the influence of establishing a protocol for the use of combined sodium benzoate and sodium phenylacetate (SBSP) (Ammonul®) to treat acute hyperammonemia. This was a retrospective, single‐center study in a 24‐bed medical and surgical pediatric intensive care unit (PICU) in a tertiary care teaching maternal–child hospital in Canada. Inclusion criteria were age < 18 years, PICU admission between 1 January 2000 and 30 June 2016, and SBSP treatment. An SBSP delivery protocol was implemented in our hospital on 30 August 2008 in order to improve management of acute hyperammonemia. Patients were assigned to one of the two groups, without or with protocol, depending on date of admission. SBSP was ordered 34 times during the study period, and 23 orders were considered for analysis (14 with and 9 without protocol). Patient characteristics were similar between groups. The median time from diagnosis to prescription was significantly shorter in the protocol group [40 min (21–82) vs 100 min (70–150), p = 0.03)] but the median time from diagnosis to administration of the treatment was equivalent [144 min (90–220) vs 195 (143–274), (p = 0.2)]. Other clinical outcomes did not differ. This study is the first to compare two SBSP delivery strategies in the treatment of acute hyperammonemia in this PICU setting. Implementation of a delivery protocol shortened the time from diagnosis of hyperammonemia to prescription of SBSP and helped us identify other parameters that can be improved to optimize treatment delivery. [ABSTRACT FROM AUTHOR]
Published: 2019
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21. Acute pediatric hyperammonemia: current diagnosis and management strategies.

Author: Savy, Nadia, Brossier, David, Brunel-Guitton, Catherine, Ducharme-Crevier, Laurence, Pont-Thibodeau, Geneviève Du, and Jouvet, Philippe
Abstract: Acute hyperammonemia may induce a neurologic impairment leading to an acute life-threatening condition. Coma duration, ammonia peak level, and hyperammonemia duration are the main risk factors of hyperammonemia-related neurologic deficits and death. In children, hyperammonemia is mainly caused by severe liver failure and inborn errors of metabolism. In an acute setting, obtaining reliable plasma ammonia levels can be challenging because of the preanalytical difficulties that need to be addressed carefully. The management of hyperammonemia includes 1) identification of precipitating factors and cerebral edema presence, 2) a decrease in ammonia production by reducing protein intake and reversing catabolism, and 3) ammonia removal with pharmacologic treatment and, in the most severe cases, with extracorporeal therapies. In case of severe coma, transcranial Doppler ultrasound could be the method of choice to noninvasively monitor cerebral blood flow and titrate therapies. [ABSTRACT FROM AUTHOR]
Published: 2018
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22. Liver Failure and the Brain

Author: Thibodeau, Genevieve Du Pont, Crevier, Laurence Ducharme, Jouvet, Philippe, editor, and Alvarez, Fernando, editor
Published: 2021
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23. Processus de validation d’une base de données haute résolution dans une unité de soins intensifs pédiatriques

Author: Mathieu, Audrey and Jouvet, Philippe
Subjects: Database, Critical care, Pédiatrie, Electronic health record, Base de données, Dossier clinique informatisé, Soins intensifs, Pediatrics
Abstract: Objectif : Notre objectif était d’évaluer la qualité des données de la base de données haute résolution (BDHR) implantée dans l’unité de soins intensifs pédiatriques (USIP) de l’Hôpital Sainte-Justine (HSJ). Type d’étude : Un rapport descriptif et une analyse d’une étude prospective de validation d’une BDHR. Environnement : Une USIP de 32 lits, adaptée aux soins médicaux, chirurgicaux et cardiaques dans un centre tertiaire mère-enfant du Canada. Population : Tous les patients admis à l’USIP et ayant un monitorage d’au moins 1 signe vital par un moniteur cardio-respiratoire. Mesures et résultats principaux : Entre juin 2017 et août 2018, les données de 295 jours de patients ont été enregistrées à partir des appareils médicaux et 4465 données ont été filmées et comparées aux données correspondantes dans la BDHR de l’USIP de l’HSJ. Les analyses statistiques ont démontré en général une bonne corrélation, une excellente fiabilité et un bon agrément. Les graphiques de Bland-Altman ont aussi démontré l’exactitude et la précision entre les données récoltées et les données filmées selon les limites d’agrément cliniquement significatives préalablement définies. Conclusions : Cette étude de validation exécutée sur un échantillon représentatif a démontré que la qualité des données était globalement excellente., Objective: Our objective was to evaluate the data quality of our high-resolution electronic database (HRDB) implemented in the pediatric intensive care unit (PICU) of HSJ. Design: A descriptive report and analysis of a prospective validation of a HRDB. Setting: A 32 beds pediatric medical, surgical and cardiac PICU in a tertiary care free-standing maternal-child health center in Canada. Population: All patients admitted to the PICU with at least one vital sign recorded using a cardiorespiratory monitor connected to the central monitoring station. Measurements and Main Results: Between June 2017 and August 2018, data from 295 patient days were recorded from medical devices and 4,645 data points were video recorded and compared to the corresponding data collected in the HSJ-PICU HRDB. Statistical analysis showed excellent overall correlation, agreement and reliability. Bland-Altman analysis showed excellent accuracy and precision between recorded and collected data within clinically significant pre-defined limits of agreement. Conclusions: This prospective validation study performed on a representative sample showed excellent overall data quality.
Published: 2020

24. Evaluating the feasibility and impact of a synchronous health technology innovation in the provision of pediatric health care in a University Hospital

Author: Nadar, Mahmoud, Sicotte, Claude, and Jouvet, Philippe
Subjects: Speech-language pathologists, Pédiatrie, Pediatric intensive care, Fellows, Acute care, Performance de voix, Résultats cliniques, Télésanté, Soins aigus, Critical care, Télémédecine synchrone, Telehealth, Voice performance, Revue systématique, Clinical outcomes, Systematic review, e-health, Soins intensifs, Synchronous telemedicine, Soins critiques, Orthophonistes
Abstract: La prestation de soins critiques et d'orthophonie en milieu pédiatrique nécessite beaucoup de travail pour atteindre le niveau de soins souhaité. Plusieurs facteurs contribuent à ce problème, parmi lesquels la pénurie de ressources, les besoins pressants et l’augmentation du nombre d’enfants malades. Parmi les solutions proposées, beaucoup pensent que la télémédecine synchrone peut être utile en donnant un accès virtuel immédiat aux compétences à distance. Ainsi, l'expertise pourrait être instantanément disponible via une plateforme permettant une communication efficace et capable de soutenir les soins pédiatriques. La télémédecine s’est beaucoup développée dans la prestation des soins critiques et de réadaptation pédiatriques, et ce aux plans diagnostique et thérapeutique. Pourtant, peu d’études ont examiné la faisabilité et évalué l’impact de la télémédecine sur la qualité des soins critiques et de réadaptation pédiatrique. L'objectif principal de cette thèse était d'évaluer la faisabilité de la télémédecine synchrone dans deux contextes pédiatriques, critique et réadaptation, et d'évaluer son influence sur le processus de prestation de soins pédiatriques. Le premier article présente les résultats d'une revue systématique qui synthétisait des études évaluant l'impact des modèles de télémédecine synchrone sur les résultats cliniques dans les établissements de soins de courte durée en pédiatrie. Les résultats ont révélé que l’utilisation de la télémédecine synchrone avait pour effet d’améliorer la qualité des soins, de diminuer le taux de transfert, de réduire de la durée du séjour, de modifier ou renforcer le plan de soins médicaux, de réduire les complications et la gravité de la maladie, et de diminuer le taux de mortalité hospitalière et standardisé. Cependant, la revue de l’état de connaissances a révélé que la qualité des études incluses était faible et que des preuves de haute qualité étaient nécessaires. Le deuxième article, fondé sur un devis pré/post, évalue la faisabilité de la télémédecine à domicile en orthophonie et son impact sur la satisfaction des enfants et orthophonistes, le coût économique, et les performances vocales. Cette étude a montré que la télémédecine en orthophonie était faisable et que les enfants et les orthophonistes étaient satisfaits du service. En outre, l'utilisation de la télémédecine en orthophonie a permis d'améliorer la voix et de faire économiser de l'argent aux parents. Le troisième article évalue la faisabilité de la mise en place d’une plate-forme de télémédecine synchrone dans l’unité des soins intensifs pédiatriques (USIP). Pour qu'une solution de télémédecine synchrone à l’USIP soit faisable, elle nécessite une bonne préparation préalable à la mise en œuvre de la plate-forme de télémédecine synchrone pour être réellement utile. Avec des médecins résidents compétents et autonomes, l’utilité d’une plate-forme de télémédecine synchrone reliant les intensivistes pédiatriques hors site et les médecins résidents sur site à l’USIP est faible. Cette étude a ajouté qu'un tel service pourrait être plus bénéfique que le modèle traditionnel des soins (face à face) pour les communications avec d'autres établissements de soins de santé éloignés, où le besoin d'expertise d'un intensiviste en soins intensifs pédiatriques est plus important. Ces trois études permettent de conclure que la télémédecine synchrone est réalisable et peut avoir un impact sur la qualité des soins intensifs et de réadaptation pédiatrique. On peut déduire de cette thèse qu'il est important de prendre en compte le contexte dans lequel la technologie sera mise en œuvre. Traiter le contexte de l’USIP et celui de réadaptation de la même manière n'aboutit pas aux mêmes résultats et une innovation technologique pourrait réussir dans un contexte et échouer dans un autre., Delivering critical and speech-language pathology care in pediatric settings requires much hard work to reach the desired level of care for children. Several factors contribute to this problem, including resources shortage, pressing needs, and the growing number of ill children. Among the proposed solutions, many believe that synchronous telemedicine can play a role by providing virtual and immediate access to remote skills, with expertise could be made instantly available through a platform that allows efficient communication and is able to support pediatric care. Telemedicine has developed significantly in the provision of critical care and pediatric rehabilitation in terms of diagnosis and therapy. Yet, few studies have examined the feasibility and evaluated the impact of telemedicine on the quality of pediatric critical care and rehabilitation. The main objective of this dissertation was to assess the feasibility of synchronous telemedicine in two pediatric settings—critical care and rehabilitation—and to evaluate its influence on the process of providing pediatric care. The first article presented the results of a systematic review that synthesized studies evaluating the impacts of synchronous telemedicine models on clinical outcomes in pediatric acute care settings. The findings revealed that the use of synchronous telemedicine improved quality of care and resulted in a lower transfer rate, a shorter length of stay, a change in or reinforcement of the medical care plan, a reduction in complications and illness severity, and a low hospital standardized mortality rate. However, the review of the state of knowledge revealed that the quality of the included studies was weak, so more high-quality evidences is needed. The second article, which used a pre/post design, assesses the feasibility assessed the feasibility of home-based telepractice in speech-language pathology (TSLP) and its impact on satisfaction among the children and speech-language pathologists, economic cost, and voice performance. This study showed that TSLP is feasible and that both the children and the speech-language pathologists were satisfied with the service. In addition, the use of TSLP demonstrated more voice improvement at less cost to the parents. The third article evaluated the feasibility of implementing a synchronous telemedicine platform in a pediatric intensive care unit (STEP-PICU). For a STEP-PICU to be feasible and truly helpful, it needs good preparation for the implementation of the telemedicine solution. With competent and autonomous fellows (a fellow is a physician who has completed their residency and elects to complete further training in a subspecialty), the usefulness of an synchronous telemedicine (STM) platform linking off-site pediatric intensivists and on-site fellows in a PICU is limited. This study added that such a service could be more beneficial than the traditional model of care (face to face) for communications with other remote healthcare facilities, where there is a greater need for the expertise of a pediatric critical care intensivist. These three studies allow us to conclude that STM is feasible and can have an impact on the quality of pediatric intensive care and rehabilitation. This thesis underscores the importance of taking into consideration the context in which the technology will be implemented. Treating the PICU and the rehabilitation contexts in the same way does not lead to the same results, and a technological innovation that succeeds in one setting may fail in another.
Published: 2020

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24 results on '"Jouvet, Philippe"'

1. Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study.

2. Reorganizing Care With the Implementation of Electronic Medical Records: A Time-Motion Study in the PICU.

3. Mechanical Ventilation and Decision Support in Pediatric Intensive Care.

4. Renal Function Follow-Up and Renal Recovery After Acute Kidney Injury in Critically Ill Children.

5. The influence of corticosteroid treatment on the outcome of influenza A(H1N1pdm09)-related critical illness.

6. Critical care capacity in Canada: results of a national cross-sectional study.

7. How to manage ventilation in pediatric acute respiratory distress syndrome?

8. Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies.

9. High-volume hemofiltration for critically ill children with acute liver failure: a standard treatment?*.

10. Acute rehabilitation practices in critically ill children: a multicenter study.

11. Shared Sensemaking and Clinical Decision-Making in Critical Care from a SA-Oriented Dashboard

12. Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.

13. Antimicrobial treatment duration for uncomplicated bloodstream infections in critically ill children: a multicentre observational study

14. Influence of implementing a protocol for an intravenously administered ammonia scavenger on the management of acute hyperammonemia in a pediatric intensive care unit

15. Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

16. Acceptable respiratory physiologic limits for children during weaning from mechanical ventilation

17. Using research to prepare for outbreaks of severe acute respiratory infection

18. Validation process of a high‐resolution database in a paediatric intensive care unit—Describing the perpetual patient's validation.

19. The implementation of a synchronous telemedicine platform linking off-site pediatric intensivists and on-site fellows in a pediatric intensive care unit: A feasibility study.

20. Influence of implementing a protocol for an intravenously administered ammonia scavenger on the management of acute hyperammonemia in a pediatric intensive care unit.

21. Acute pediatric hyperammonemia: current diagnosis and management strategies.

22. Liver Failure and the Brain

23. Processus de validation d’une base de données haute résolution dans une unité de soins intensifs pédiatriques

24. Evaluating the feasibility and impact of a synchronous health technology innovation in the provision of pediatric health care in a University Hospital

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