PHRC Ncelebrated its 30th anniversary!

Each year, the Directorate General for Healthcare Provision (DGOS) launches this call for research projects, allowing hospital teams to submit applications in order to obtain funding, with a threefold objective:

• To boost hospital-based clinical research in order to promote medical progress;
• To participate in improving the quality of care through the evaluation of new diagnostic and therapeutic methods;
• To scientifically validate new medical knowledge in order to identify therapeutic innovations and implement dissemination strategies in the health system.

Since 1993, the Caen Normandy University Hospital has obtained 162 funded projects. Two projects led by the intensive care and resuscitation were particularly significant for the institution.

Central venous catheters (CVCs) have potentially serious but rare complications, such as catheter-related infections, deep vein thrombosis (DVT), and pneumothorax.

The PHRC was designed to examine whether subclavian, internal jugular or femoral access was associated with a difference in the rate of major catheter-related complications combining catheter-related infection or symptomatic DVT.

With 3,027 patients included over three years in France, this study demonstrated that subclavian vein catheterization was associated with a lower risk of CVC-related infection and symptomatic thrombosis, but a higher risk of pneumothorax than jugular or femoral vein catheterization.

It has had a considerable scientific impact (742 citations on Google Scholar) and has contributed to changing national and international recommendations (Timsit ICM 2018, Buetti ICHE 2022, O'Grady NEJM 2023) for the most frequently performed invasive procedure in resuscitation.

In respiratory distress in people with chronic obstructive pulmonary disease (COPD), a bacterial infection is not always the cause.

The 2010 randomized inter-regional PHRC BPCTréa proposed to evaluate the benefit of procalcitonin-guided antibiotic therapy (PCT) on the morbidity and mortality of COPD patients hospitalized in intensive care for exacerbation with or without associated pneumonia

Of the 302 patients included, 30 patients (20%) in the PCT group and 21 patients (14%) in the control group died within 3 months of admission. The duration of antibiotic exposure in the ICU was similar between the PCT and control groups. The PCT algorithm was not non-inferior and did not reduce the duration of antibiotic therapy in the tested setting (Daubin, ICM 2018).

This high-level evidence study with significant scientific impact (100 citations on Google Scholar) has contributed to changing national and international recommendations (Schuetz CCLM 2019).