French intensive care unit organisation

Marc Leone; Jean-Michel Constantin; Claire Dahyot-Fizelier; Caroline Duracher-Gout; Olivier Joannes-Boyau; Olivier Langeron; Matthieu Legrand; Yazine Mahjoub; Sébastien Mirek; Ségolène Mrozek; Laurent Muller; Jean-Christophe Orban; Christophe Quesnel; Antoine Roquilly; Antoine Virat; Xavier Capdevila

doi:10.1016/j.accpm.2018.10.011

French intensive care unit organisation

Anaesth Crit Care Pain Med. 2018 Dec;37(6):625-627. doi: 10.1016/j.accpm.2018.10.011. Epub 2018 Oct 25.

Authors

Marc Leone¹, Jean-Michel Constantin², Claire Dahyot-Fizelier³, Caroline Duracher-Gout⁴, Olivier Joannes-Boyau⁵, Olivier Langeron⁶, Matthieu Legrand⁷, Yazine Mahjoub⁸, Sébastien Mirek⁹, Ségolène Mrozek¹⁰, Laurent Muller¹¹, Jean-Christophe Orban¹², Christophe Quesnel¹³, Antoine Roquilly¹⁴, Antoine Virat¹⁵, Xavier Capdevila¹⁶

Affiliations

¹ Aix Marseille université, AP-HM, anaesthesia and intensive care medicine, hôpital Nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: marc.leone@ap-hm.fr.
² Department of perioperative medicine, university hospital of Clermont-Ferrand, 1, place Lucie-Aubrac, 63103 Clermont-Ferrand, France.
³ Department of anaesthesia and intensive care, university hospital of Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
⁴ Department of anaesthesiology and critical care medicine, hôpital universitaire Necker-Enfants-Malades, AP-HP, University Paris Descartes, 149, rue de Sèvres, 75743 Paris, France.
⁵ Department of anaesthesia and intensive care, Magellan university hospital, 1, avenue de Magellan, 33600 Pessac, France.
⁶ Multidisciplinary intensive care unit, department of anaesthesiology and critical care, hôpital de la Pitié-Salpêtrière, assistance publique-hôpitaux de Paris, Sorbonne université, 75013 Paris, France.
⁷ Department of anaesthesia and intensive care, Saint-Louis hospital, 1, avenue Claude-Vellefaux, 75010 Paris, France.
⁸ Department of anaesthesiology and critical care medicine, Amiens-Picardie university Hospital, 80054 Amiens, France.
⁹ Department of anaesthesia and intensive care, Dijon university hospital, BP 77908, 21709 Dijon, France.
¹⁰ Department of anaesthesia and intensive care, university hospital of Toulouse, university Toulouse 3 Paul Sabatier, 31000 Toulouse, France.
¹¹ Intensive care, anaesthesia, pain, emergency and intensive care department, centre hospitalier universitaire Carémeau, 30000 Nîmes, France.
¹² Medical surgical ICU, Pasteur 2 hospital, Nice university hospital, 30, voie Romaine, 06001 Nice, France.
¹³ Assistance publique-hôpitaux de Paris, hôpital Tenon, department of anaesthesia and intensive care and perioperative medicine, groupe hospitalier des hôpitaux universitaires de l'Est Parisien, Sorbonne Université, 75020 Paris, France.
¹⁴ Intensive care unit, anaesthesia and critical care department, Hôtel Dieu, university hospital of Nantes, 44000 Nantes, France.
¹⁵ Clinique Pont De Chaume, 330, avenue Marcel Unal, 82000 Montauban, France.
¹⁶ Department of anaesthesia and intensive care, Lapeyronie university hospital, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.

PMID: 30580776
DOI: 10.1016/j.accpm.2018.10.011

Abstract

Anaesthesia, Critical Care and Pain Medicine is the journal of the French Society of Anaesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie et de Réanimation), aimed at promoting the French approach to anaesthesiology, critical care and perioperative medicine. Here, the Intensive Care Committee of the French Society of Anaesthesia and Intensive Care Medicine provides an overview of the organisation of the 400 French Intensive Care Units (ICU), which are polyvalent (50%), surgical (20%), or medical (12%). Around 150,000 patients are admitted to these units each year. Law Decrees govern the frame of practices, including architecture, nurse staffing - two nurses for five patients and one nurse-assistant for four patients - and 24/7 medical coverage. The daily cost of ICU hospitalisation is around 1425 €, entirely ensured by the National Health System. The clinical practices are variable but guidelines produced by intensivists are invited to adhere to guidelines available and freely accessible. End-of-life practices are framed by a Law Decree (Claeys Léonetti) aiming at protecting patients against stubbornly and unreasonable cares. The biomedical research plays a critical role in the French ICU, and practices are performed under the supervision of the Jardé Law. An Institutional Research Board approval is required for prospective studies. In conclusion, the French ICU practice is surrounded by a legal frame.

Keywords: Intensive care; Law decree; Organisation; Programs.

Publication types

Letter

MeSH terms

Critical Care
France
Humans
Intensive Care Units / economics
Intensive Care Units / legislation & jurisprudence
Intensive Care Units / organization & administration*
Intensive Care Units / statistics & numerical data
Patient Admission
Terminal Care