Comments on "Pediatric intensive care: result of a European survey"

Excerpt

Sir: In their recent study Nipshagen et al. [1] sought to describe the characteristics and organizational aspects of pediatric intensive care units (PICUs) in Europe. This contribution shows some interesting results, but, unfortunately, the conclusions may lack some basis due to significant weaknesses of the methods used. For example, an important bias may be introduced by use of the database of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) to mail the questionnaire, thus assuming that "virtually all major European PICUs have at least one ESPNIC member on their staff." We are not aware of the PICU situations in other European countries, but we do have data about those in our country. In fact, the characteristics of PICUs in Spain have been published (year 2000) in Intensive Care Medicine [2]. This study was carried out by the Spanish Society of Paediatric Intensive Care using a questionnaire very similar to that of the Nipshagen et al. survey. There were 34 PICUs in Spain at the time of that enquiry; Nipshagen et al. sent their questionnaire to only nine of these, obtaining seven responses. In addition, these seven PICUs do not reflect the actual situation of pediatric critical care in our country. To support this statement we can report, for instance, that not a single one of these PICUs includes newborns, whereas 40% of PICUs in Spain do in fact include newborns [2]. Also, the average PICU size in the Nispaghen et al. study is 14 beds, but in our survey it is 8 beds [2]. The estimated number of PICU beds per inhabitant (1.58 beds per 100,000 between the ages of 1–18 years) is clearly lower than the actual number (3.5) that we ascertained [3]. …