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 less than 0.001), and more commonly admitted for emergency reasons (92% vs. 66%, P less than 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 less than 0.001; central venous catheters, 38% vs. 11%, P less than 0.001; pulmonary artery catheters, 8% vs. 1%, P less than 0.01), while the French PICU had higher incidences of labor-intensive monitoring modalities (strict input/output, 75% vs. 47%, P less than 0.0001; greater than 3 stat blood studies/shift, 69% vs. 45%, P less than 0.0001). Patients in France were more likely to receive mechanical ventilation (81% vs. 56%, P less than 0.0001) and nutritional support (40% vs. 7%, P less than 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.
journal_name
Resuscitationjournal_title
Resuscitationauthors
Davis AL,Pollack MM,Cloup M,Cloup I,Wilkinson JDdoi
10.1016/0300-9572(89)90066-xsubject
Has Abstractpub_date
1989-04-01 00:00:00pages
143-52issue
2eissn
0300-9572issn
1873-1570pii
0300-9572(89)90066-Xjournal_volume
17pub_type
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