Comparisons of French and U.S.A. pediatric intensive care units

Alan L. Davis, Murray M. Pollack, Michel Cloup, Irene Cloup, James D. Wilkinson

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Consecutive admissions to two pediatric intensive care units (PICUs) in France (n = 93) and the United States (n = 248) were compared using admission demographics, and daily therapeutic and severity of illness data. Analysis of the major demographic characteristics revealed that patients in the French PICU were younger (median age; 3 months vs. 31 months, P < 0.001), and more commonly admitted for emergency reasons (92% vs. 66%, P < 0.05). General resource utilization was similar in both units. However, important differences in the incidences of use of individual monitoring and therapeutic modalities were present. The United States PICU had higher incidences of invasive monitoring modalities (arterial catheters, 66% vs. 4%, P < 0.001; central venous catheters, 38% vs. 11%, P < 0.001; pulmonary artery catheters, 8% vs. 1%, P < 0.01), while the French PICU had higher incidences of labor-intensive monitoring modalities (strict input/output, 75% vs. 47%, P < 0.0001; > 3 stat blood studies/shift, 69% vs. 45%, P < 0.0001). Patients in France were more likely to receive mechanical ventilation (81% vs. 56%, P < 0.0001) and nutritional support (40% vs. 7%, P < 0.05). Mortality rates in both PICUs were similar and accurately predicted by admission-day severity of illness scores. We conclude that differential resource utilization, possibly arising from different care philosophies, may result in equivalent care.

Original languageEnglish
Pages (from-to)143-152
Number of pages10
JournalResuscitation
Volume17
Issue number2
DOIs
StatePublished - Jan 1 1989

Keywords

  • Critical care
  • Health care resources
  • Intensive care
  • Pediatrics
  • Severity of illness

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

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    Davis, A. L., Pollack, M. M., Cloup, M., Cloup, I., & Wilkinson, J. D. (1989). Comparisons of French and U.S.A. pediatric intensive care units. Resuscitation, 17(2), 143-152. https://doi.org/10.1016/0300-9572(89)90066-X