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Master Thesis

Evaluation du niveau de traitement des enfants polyhandicapés hospitalisés en urgence en réanimation médicale pédiatrique en île de France

Abstract : Introduction : Children with polyhandicaps are a complex medical and ethical situation. There are few studies about their admission in intensive care units, despite them having a strong risk of acute diseases. Objectives : To describe the hospitalization of children with polyhandicaps in pediatric intensive care units. Patients and methods : This is a retrospective study in 4 pediatric intensive care units in Paris. children with polyhandicaps hospitalized in emergency from January 1st 2013 to December 31st 2015 were included. We looked at epidemiological datas, medical supports and medications at admission and treatment level (respiratory, circulatory, neurologic, invasive procedures), and limitations of treatments. Results : 96 patients were included, representing 143 hospitalizations. At admission average age was 11±5 years, mean number of medical support per patient was 1±0,8 and mean number of neurological medication per patient was 2,5±1,8. The main admission criteria were : respiratory failures (59%), neurological failures (17%) and circulatory failures (10%). Respiratory support was needed in 56%, circulatory support in 31% and nutritional support in 20% of patients. Forty-two percent of patients did not have to be submitted to any invasive procedures. During these hospitalizations 25 consultation meetings have been held. Overall mortality was 16%. Conclusion : children with polyhandicaps admitted in intensive care units are at school age and are mostly having respiratory or neurological failures. There is a strong rate of rehospitalisation. There are few therapeutic limitations that have been found today. Anticipating a crisis is a major point to provide the best care for these children.
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Master Thesis
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Jérémie Tencer. Evaluation du niveau de traitement des enfants polyhandicapés hospitalisés en urgence en réanimation médicale pédiatrique en île de France. Médecine humaine et pathologie. 2017. ⟨dumas-02479179⟩

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