Children with chronic conditions in pediatric intensive care units located in predominantly French-speaking regions: Prevalence and implications on rehabilitation care need and utilization. , and the GFRUP/RMEF chronic diseases in PICU study group

Abstract : Objective: To estimate the prevalence of chronic conditions and/or disability in intensive care units admitting children (PICU) or both neonates and children (NPICU), and to describe available rehabilitation resources. Design: A cross-sectional study on two separate days, using a web questionnaire. Setting: NPICU/PICUs affiliated to the Groupe Francophone de Réanimation et Urgences Pédiatriques and the Réseau Mère-Enfant de la Francophonie Patients: Children > 1 month of gestationally corrected age. Measurements and Main Results: Disability was defined as a Pediatric Overall Performance Category (POPC) 3 before admission and chronic conditions as hospitalization since birth or the presence before admission of any condition requiring on-going pediatric subspecialty care that was expected to last >12 months. Intensivists indicated what rehabilitation services he would have ideally prescribed (“perceived needs”) and those provided. Of 45 affiliated units 8 PICUs and 15 NPICUs participated. Staff included or had access to a psychologist (11 and 5, respectively), a social worker (10 and 3), a physiotherapist (11 and 12), a «psychomotrician» (2 and 8), a child educator (1 and 6), and a speech-language pathologist (0 and 6). Among 289 recorded ICU-days, 236 were analyzed (excluding those for children admitted after surgery): 57 concerned children hospitalized since birth and 179 children admitted from home. Among these 179 recorded ICU-days, 107 concerned children with chronic conditions (including 50 concerning disabled children) and 72 previously healthy children. Thus, prevalence of chronic conditions, including children hospitalized since birth, was 67%. Rehabilitation services included: respiratory physical therapy (552 visits), musculoskeletal physical therapy (71), neurological physical therapy (37), rehabilitation for swallowing (11), and for speech-language disorders (1), representing 79% of perceived needs. Conclusions: Prevalence of chronic conditions in NPICU/PICU was 67%. More attention must be paid to the rehabilitation care needs of patients during their NPPICU/PICU stay and after discharge.
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Critical Care Medicine, Lippincott, Williams & Wilkins, 2009, 37 ((4)), pp.1456-62
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Robin Cremer, Francis Leclerc, Jacques Lacroix, Dominique Ploin. Children with chronic conditions in pediatric intensive care units located in predominantly French-speaking regions: Prevalence and implications on rehabilitation care need and utilization. , and the GFRUP/RMEF chronic diseases in PICU study group. Critical Care Medicine, Lippincott, Williams & Wilkins, 2009, 37 ((4)), pp.1456-62. 〈inserm-01371859〉

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