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| ID | Type | Description | Link |
|---|---|---|---|
| 2018-A00763-52 | Other Identifier | ID-RCB |
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Abandoned study project
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| Name | Class |
|---|---|
| URC-CIC Paris Descartes Necker Cochin | OTHER |
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The purpose of this study is to introduce delirium detection and try to determine the prevalence of delirium in Pediatric Intensive Care Unit (PICU) using a validated tool : the Cornell Assessment of Pediatric Delirium (CAPD) for every patient twice a day.
Delirium is a frequent affection in ICU. In adult population, its prevalence is 20-50% in non intubated patients and 60-80% in patients under invasive ventilation. It is also frequent in paediatric population, but less diagnosed, whereas it can lead to higher duration stay, higher morbidity, traumatic injuries, acute stress, memory losses and post-traumatic stress syndrome. Since 2016, international guidelines recommend to look for delirium in paediatric population in PICU. There are 3 recommended tools to diagnose this affection: psCAM-ICU (6 months-5 years old), pCAM-ICU (5 years old-18 years old) and CAPD (birth-18 years old).
None of these validated tools have been translated in French.
The principal objective is to study the practicability of twice a day detection of delirium in PICU using the CAPD.
Investigators will first used a validation process to translate the CAPD in French, based on the validation method for psychological questionnaires suggested by Vallerand.
Then they will ask the paramedics to evaluate through the CAPD every consecutive patient/12 hours, every day during their stay in PICU, except for those completely unresponsive or under curare. This systematic evaluation will take place for 2 consecutive months.
For every patient, data will be collected about their age, sexe, term of birth, mental affection status, diagnosis at entry, and daily risk of mortality score, length of stay, ventilation, pain evaluation and treatment, withdrawal evaluation, surroundings, use of hypnotic treatment, steroids, opioids and ketamine.
The secondary aims are to determine the prevalence of delirium with the data collected, to ask whether or not the French version of CAPD has been easily and correctly used, can help to diagnose delirium, and whether investigators can find some associated parameters to delirium.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CAPD | Diagnostic Test | CAPD evaluation every day per 12hours during their stay in PICU |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of delirium in the PICU population | Number of CAPD evaluated > 9 / total number of CAPD evaluated | 2 months |
| Measure | Description | Time Frame |
|---|---|---|
| Applicability of the CAPD by the paramedics | 5 questions :
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Inclusion Criteria:
Exclusion Criteria:
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Patients aged 0 to 18 years hospitalized in PICU at Necker Children's Hospital
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| Name | Affiliation | Role |
|---|---|---|
| Laure De Saint Blanquat, MD, PhD | Assistance Publique - Hôpitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Necker Enfants Malades Hospital | Paris | 75015 | France |
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| ID | Term |
|---|---|
| D003693 | Delirium |
| ID | Term |
|---|---|
| D003221 | Confusion |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Before inclusion period |
| Applicability of the CAPD by the paramedics after the 2 months period | The same 5 questions of the pre-test, 5 new closed-ended questions and 3 open-ended questions :
1- If difficulties of evaluating patients with the CAPD : quote the difficulties 2- In which categories of patients do they think that the CAPD in not adapted 3- Comment or suggestions to improve the use of the scale | 2 months |
| Use of the CAPD by the paramedics | % of CAPD completed during the 2 months period | 2 months |
| Age | Potential associated factors to delirium | 2 months |
| Sex | Potential associated factors to delirium | 2 months |
| Term of birth | Potential associated factors to delirium | 2 months |
| Prior neurological impairment | Potential associated factors to delirium | 2 months |
| Diagnosis (motivating hospitalization in intensive care) | Potential associated factors to delirium | 2 months |
| Severity score on arrival (PIM 3) | Potential associated factors to delirium. Pediatric Index of Mortality (PIM) 3 is a published and open acces program whith 10 variables about the patients (7 binary variables and 3 quantitative ones), that predicts the death probability of the patient. One evaluation per patient at the admission in the PICU unit. | 2 months |
| Daily severity score (PELOD 2) | Potential associated factors to delirium. PELOD 2 (PEdiatric Logistic Organ Dysfunction) is a published and open acces program that includes ten variables corresponding to five organ dysfunctions. It predicts a daily percentage of mortality. One evaluation per day per patient during the PICU unit stay. | 2 months |
| Duration of hospitalization | Potential associated factors to delirium | 2 months |
| Death or survival of the patient | Potential associated factors to delirium | 2 months |
| Mechanical ventilation, non invasive ventilation or spontaneous ventilation | Potential associated factors to delirium | 2 months |
| Mechanical ventilation time | Potential associated factors to delirium | 2 months |
| Presence of parents | Potential associated factors to delirium | 2 months |
| Presence of pain | Potential associated factors to delirium. Pain was evaluated through the appropriate scale amongst :
Patients able to assess pain felt :
| 2 months |
| withdrawal or not | Potential associated factors to delirium. Withdrawal was evaluated through the scale WAT-1 (Wthdrawal Assessing tool version 1): ten items scored 0 or 1, and 1 item scored 0 to 2, a total score greater than or equal to 3/12 indicating a state of withdrawal. | 2 months |
| Use of benzodiazepines, ketamine, corticosteroids or opioids | Potential associated factors to delirium | 2 months |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |