Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic
Identifieur interne : 000562 ( France/Analysis ); précédent : 000561; suivant : 000563Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic
Auteurs : Jean-Christophe Marie Richard [France, Suisse] ; Tài Pham [France] ; Christian Brun-Buisson [France] ; Jean Reignier [France] ; Alain Mercat [France] ; Gaëtan Beduneau [France] ; Bernard Régnier [France] ; Bruno Mourvillier [France] ; Christophe Guitton [France] ; Matthias Castanier [France] ; Alain Combes [France] ; Yves Le Tulzo [France] ; Laurent Brochard [Suisse]Source :
- Critical Care [ 1364-8535 ] ; 2012.
Abstract
The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs.
We conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden.
Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas.
The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs.
Url:
DOI: 10.1186/cc11412
PubMed: 22776231
PubMed Central: 3580695
Affiliations:
- France, Suisse
- Haute-Normandie, Pays de la Loire, Provence-Alpes-Côte d'Azur, Région Bretagne, Région Normandie, Île-de-France
- Nantes
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PMC:3580695Le document en format XML
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Médicale, Centre Hospitalier Universitaire l'Hôtel Dieu, 1 place Alexis-Ricordeau, Nantes, 44093, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, Centre Hospitalier Universitaire l'Hôtel Dieu, 1 place Alexis-Ricordeau, Nantes, 44093</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region></placeName></affiliation></author><author><name sortKey="Castanier, Matthias" sort="Castanier, Matthias" uniqKey="Castanier M" first="Matthias" last="Castanier">Matthias Castanier</name><affiliation wicri:level="3"><nlm:aff id="I11">Service de Réanimation, détresses respiratoires et infections sévères, AP-HM, Hôpital Nord, Chemin des Bourelly, Marseille, 13915, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation, détresses respiratoires et infections sévères, AP-HM, Hôpital Nord, Chemin des Bourelly, Marseille, 13915</wicri:regionArea><placeName><region type="region" 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de Germont, Rouen, 76031</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">UPRES EA 3830 (IFR MP23), Institute for Biomedical Research, 22 Boulevard Gambetta, Rouen, 76183, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>UPRES EA 3830 (IFR MP23), Institute for Biomedical Research, 22 Boulevard Gambetta, Rouen, 76183</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Department of Intensive Care, Geneva University Hospital and Geneva University, 4 Rue Gabrielle-Perret-Gentil, Geneva, 1205, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Intensive Care, Geneva University Hospital and Geneva University, 4 Rue Gabrielle-Perret-Gentil, Geneva, 1205</wicri:regionArea><wicri:noRegion>1205</wicri:noRegion></affiliation></author><author><name sortKey="Pham, Tai" sort="Pham, Tai" uniqKey="Pham T" first="Tài" last="Pham">Tài Pham</name><affiliation wicri:level="3"><nlm:aff id="I4">Service de Réanimation Médicale, AP-HP, Groupe Hospitalier Universitaire Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, AP-HP, Groupe Hospitalier Universitaire Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Brun Buisson, Christian" sort="Brun Buisson, Christian" uniqKey="Brun Buisson C" first="Christian" last="Brun-Buisson">Christian Brun-Buisson</name><affiliation wicri:level="3"><nlm:aff id="I4">Service de Réanimation Médicale, AP-HP, Groupe Hospitalier Universitaire Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, AP-HP, Groupe Hospitalier Universitaire Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94000</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I5">Inserm U955, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 61 Avenue du Général de Gaulle, Créteil, 94010, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Inserm U955, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 61 Avenue du Général de Gaulle, Créteil, 94010</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Reignier, Jean" sort="Reignier, Jean" uniqKey="Reignier J" first="Jean" last="Reignier">Jean Reignier</name><affiliation wicri:level="3"><nlm:aff id="I6">Service de Réanimation Polyvalente, Centre Hospitalier Départemental de la Vendée, Les Oudairies, La Roche sur Yon, 85000, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Polyvalente, Centre Hospitalier Départemental de la Vendée, Les Oudairies, La Roche sur Yon, 85000</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region></placeName></affiliation></author><author><name sortKey="Mercat, Alain" sort="Mercat, Alain" uniqKey="Mercat A" first="Alain" last="Mercat">Alain Mercat</name><affiliation wicri:level="3"><nlm:aff id="I7">Service de Réanimation Médicale et de médecine hyperbare, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, Angers, 49933, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale et de médecine hyperbare, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, Angers, 49933</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I8">LUNAM, Université Nantes Angers Le Mans, 19 bis rue La Nouë Bras de Fer, Nantes, 44200 France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>LUNAM, Université Nantes Angers Le Mans, 19 bis rue La Nouë Bras de Fer, Nantes</wicri:regionArea><placeName><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Beduneau, Gaetan" sort="Beduneau, Gaetan" uniqKey="Beduneau G" first="Gaëtan" last="Beduneau">Gaëtan Beduneau</name><affiliation wicri:level="3"><nlm:aff id="I1">Service de Réanimation Médicale, Centre Hospitalier Universitaire Charles Nicolle, 1 rue de Germont, Rouen, 76031, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, Centre Hospitalier Universitaire Charles Nicolle, 1 rue de Germont, Rouen, 76031</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">UPRES EA 3830 (IFR MP23), Institute for Biomedical Research, 22 Boulevard Gambetta, Rouen, 76183, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>UPRES EA 3830 (IFR MP23), Institute for Biomedical Research, 22 Boulevard Gambetta, Rouen, 76183</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region></placeName></affiliation></author><author><name sortKey="Regnier, Bernard" sort="Regnier, Bernard" uniqKey="Regnier B" first="Bernard" last="Régnier">Bernard Régnier</name><affiliation wicri:level="3"><nlm:aff id="I9">Service de Réanimation Médicale, AP-HP, Centre Hospitalier Universitaire Bichat Claude Bernard, 46, rue Henri-Huchard, Paris, 75018, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, AP-HP, Centre Hospitalier Universitaire Bichat Claude Bernard, 46, rue Henri-Huchard, Paris, 75018</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Mourvillier, Bruno" sort="Mourvillier, Bruno" uniqKey="Mourvillier B" first="Bruno" last="Mourvillier">Bruno Mourvillier</name><affiliation wicri:level="3"><nlm:aff id="I9">Service de Réanimation Médicale, AP-HP, Centre Hospitalier Universitaire Bichat Claude Bernard, 46, rue Henri-Huchard, Paris, 75018, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, AP-HP, Centre Hospitalier Universitaire Bichat Claude Bernard, 46, rue Henri-Huchard, Paris, 75018</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Guitton, Christophe" sort="Guitton, Christophe" uniqKey="Guitton C" first="Christophe" last="Guitton">Christophe Guitton</name><affiliation wicri:level="3"><nlm:aff id="I10">Service de Réanimation Médicale, Centre Hospitalier Universitaire l'Hôtel Dieu, 1 place Alexis-Ricordeau, Nantes, 44093, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, Centre Hospitalier Universitaire l'Hôtel Dieu, 1 place Alexis-Ricordeau, Nantes, 44093</wicri:regionArea><placeName><region type="region" nuts="2">Pays de la Loire</region></placeName></affiliation></author><author><name sortKey="Castanier, Matthias" sort="Castanier, Matthias" uniqKey="Castanier M" first="Matthias" last="Castanier">Matthias Castanier</name><affiliation wicri:level="3"><nlm:aff id="I11">Service de Réanimation, détresses respiratoires et infections sévères, AP-HM, Hôpital Nord, Chemin des Bourelly, Marseille, 13915, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation, détresses respiratoires et infections sévères, AP-HM, Hôpital Nord, Chemin des Bourelly, Marseille, 13915</wicri:regionArea><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region></placeName></affiliation></author><author><name sortKey="Combes, Alain" sort="Combes, Alain" uniqKey="Combes A" first="Alain" last="Combes">Alain Combes</name><affiliation wicri:level="3"><nlm:aff id="I12">Service de Réanimation Médicale, AP-HP, Centre Hospitalier Universitaire La Pitié Salpétrière, 47 Boulevard de l'Hôpital, Paris, 75013, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation Médicale, AP-HP, Centre Hospitalier Universitaire La Pitié Salpétrière, 47 Boulevard de l'Hôpital, Paris, 75013</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Tulzo, Yves Le" sort="Tulzo, Yves Le" uniqKey="Tulzo Y" first="Yves Le" last="Tulzo">Yves Le Tulzo</name><affiliation wicri:level="3"><nlm:aff id="I13">Service de Maladies Infectieuses et Réanimation médicale, Centre Hospitalier Universitaire Pontchaillou, Rennes, 35033, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de Maladies Infectieuses et Réanimation médicale, Centre Hospitalier Universitaire Pontchaillou, Rennes, 35033</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I14">Inserm-0203, Centre d'Investigation Clinique, Université Rennes 1, 2 rue Henri Le Guilloux, Rennes, 35033, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Inserm-0203, Centre d'Investigation Clinique, Université Rennes 1, 2 rue Henri Le Guilloux, Rennes, 35033</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region></placeName></affiliation></author><author><name sortKey="Brochard, Laurent" sort="Brochard, Laurent" uniqKey="Brochard L" first="Laurent" last="Brochard">Laurent Brochard</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Intensive Care, Geneva University Hospital and Geneva University, 4 Rue Gabrielle-Perret-Gentil, Geneva, 1205, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Intensive Care, Geneva University Hospital and Geneva University, 4 Rue Gabrielle-Perret-Gentil, Geneva, 1205</wicri:regionArea><wicri:noRegion>1205</wicri:noRegion></affiliation></author></analytic><series><title level="j">Critical Care</title><idno type="ISSN">1364-8535</idno><idno type="eISSN">1466-609X</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs.</p></sec><sec><title>Methods</title><p>We conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden.</p></sec><sec><title>Results</title><p>Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas.</p></sec><sec><title>Conclusions</title><p>The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. 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uniqKey="Zarychanski R">R Zarychanski</name></author><author><name sortKey="Pinto, R" uniqKey="Pinto R">R Pinto</name></author><author><name sortKey="Cook, Dj" uniqKey="Cook D">DJ Cook</name></author><author><name sortKey="Marshall, J" uniqKey="Marshall J">J Marshall</name></author><author><name sortKey="Lacroix, J" uniqKey="Lacroix J">J Lacroix</name></author><author><name sortKey="Stelfox, T" uniqKey="Stelfox T">T Stelfox</name></author><author><name sortKey="Bagshaw, S" uniqKey="Bagshaw S">S Bagshaw</name></author><author><name sortKey="Choong, K" uniqKey="Choong K">K Choong</name></author><author><name sortKey="Lamontagne, F" uniqKey="Lamontagne F">F Lamontagne</name></author><author><name sortKey="Turgeon, Af" uniqKey="Turgeon A">AF Turgeon</name></author><author><name sortKey="Lapinsky, S" uniqKey="Lapinsky S">S Lapinsky</name></author><author><name sortKey="Ahern, Sp" uniqKey="Ahern S">SP Ahern</name></author><author><name sortKey="Smith, O" uniqKey="Smith O">O Smith</name></author><author><name sortKey="Siddiqui, F" uniqKey="Siddiqui F">F Siddiqui</name></author><author><name sortKey="Jouvet, P" uniqKey="Jouvet P">P Jouvet</name></author><author><name sortKey="Khwaja, K" uniqKey="Khwaja K">K Khwaja</name></author><author><name sortKey="Mcintyre, L" uniqKey="Mcintyre L">L McIntyre</name></author><author><name sortKey="Menon, K" uniqKey="Menon K">K Menon</name></author><author><name sortKey="Hutchison, J" uniqKey="Hutchison J">J Hutchison</name></author><author><name sortKey="Hornstein, D" uniqKey="Hornstein D">D Hornstein</name></author><author><name sortKey="Joffe, A" uniqKey="Joffe A">A Joffe</name></author><author><name sortKey="Lauzier, F" uniqKey="Lauzier F">F Lauzier</name></author><author><name sortKey="Singh, J" uniqKey="Singh J">J Singh</name></author><author><name sortKey="Karachi, T" uniqKey="Karachi T">T Karachi</name></author><author><name sortKey="Wiebe, K" uniqKey="Wiebe K">K Wiebe</name></author><author><name sortKey="Olafson, K" uniqKey="Olafson K">K Olafson</name></author><author><name sortKey="Ramsey, C" uniqKey="Ramsey C">C Ramsey</name></author><author><name sortKey="Sharma, S" uniqKey="Sharma S">S Sharma</name></author><author><name sortKey="Dodek, P" uniqKey="Dodek P">P Dodek</name></author><author><name sortKey="Meade, M" uniqKey="Meade M">M Meade</name></author><author><name sortKey="Hall, R" uniqKey="Hall R">R Hall</name></author><author><name sortKey="Fowler, Ra" uniqKey="Fowler R">RA Fowler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eastman, N" uniqKey="Eastman N">N Eastman</name></author><author><name sortKey="Philips, B" uniqKey="Philips B">B Philips</name></author><author><name sortKey="Rhodes, A" uniqKey="Rhodes A">A Rhodes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grills, N" uniqKey="Grills N">N Grills</name></author><author><name sortKey="Piers, Ls" uniqKey="Piers L">LS Piers</name></author><author><name sortKey="Barr, I" uniqKey="Barr I">I Barr</name></author><author><name sortKey="Vaughan, Lm" uniqKey="Vaughan L">LM Vaughan</name></author><author><name sortKey="Lester, R" uniqKey="Lester R">R Lester</name></author><author><name sortKey="Magliano, Dj" uniqKey="Magliano D">DJ Magliano</name></author><author><name sortKey="Shaw, Je" uniqKey="Shaw J">JE Shaw</name></author><author><name sortKey="Carnie, Ja" uniqKey="Carnie J">JA Carnie</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li><li>Suisse</li></country><region><li>Haute-Normandie</li><li>Pays de la Loire</li><li>Provence-Alpes-Côte d'Azur</li><li>Région Bretagne</li><li>Région Normandie</li><li>Île-de-France</li></region><settlement><li>Nantes</li></settlement></list><tree><country name="France"><region name="Région Normandie"><name sortKey="Richard, Jean Christophe Marie" sort="Richard, Jean Christophe Marie" uniqKey="Richard J" first="Jean-Christophe Marie" last="Richard">Jean-Christophe Marie Richard</name></region><name sortKey="Beduneau, Gaetan" sort="Beduneau, Gaetan" uniqKey="Beduneau G" first="Gaëtan" last="Beduneau">Gaëtan Beduneau</name><name sortKey="Beduneau, Gaetan" sort="Beduneau, Gaetan" uniqKey="Beduneau G" first="Gaëtan" last="Beduneau">Gaëtan Beduneau</name><name sortKey="Brun Buisson, Christian" sort="Brun Buisson, Christian" uniqKey="Brun Buisson C" first="Christian" last="Brun-Buisson">Christian Brun-Buisson</name><name sortKey="Brun Buisson, Christian" sort="Brun Buisson, Christian" uniqKey="Brun Buisson C" first="Christian" last="Brun-Buisson">Christian Brun-Buisson</name><name sortKey="Castanier, Matthias" sort="Castanier, Matthias" uniqKey="Castanier M" first="Matthias" last="Castanier">Matthias Castanier</name><name sortKey="Combes, Alain" sort="Combes, Alain" uniqKey="Combes A" first="Alain" last="Combes">Alain Combes</name><name sortKey="Guitton, Christophe" sort="Guitton, Christophe" uniqKey="Guitton C" first="Christophe" last="Guitton">Christophe Guitton</name><name sortKey="Mercat, Alain" sort="Mercat, Alain" uniqKey="Mercat A" first="Alain" last="Mercat">Alain Mercat</name><name sortKey="Mercat, Alain" sort="Mercat, Alain" uniqKey="Mercat A" first="Alain" last="Mercat">Alain Mercat</name><name sortKey="Mourvillier, Bruno" sort="Mourvillier, Bruno" uniqKey="Mourvillier B" first="Bruno" last="Mourvillier">Bruno Mourvillier</name><name sortKey="Pham, Tai" sort="Pham, Tai" uniqKey="Pham T" first="Tài" last="Pham">Tài Pham</name><name sortKey="Regnier, Bernard" sort="Regnier, Bernard" uniqKey="Regnier B" first="Bernard" last="Régnier">Bernard Régnier</name><name sortKey="Reignier, Jean" sort="Reignier, Jean" uniqKey="Reignier J" first="Jean" last="Reignier">Jean Reignier</name><name sortKey="Richard, Jean Christophe Marie" sort="Richard, Jean Christophe Marie" uniqKey="Richard J" first="Jean-Christophe Marie" last="Richard">Jean-Christophe Marie Richard</name><name sortKey="Tulzo, Yves Le" sort="Tulzo, Yves Le" uniqKey="Tulzo Y" first="Yves Le" last="Tulzo">Yves Le Tulzo</name><name sortKey="Tulzo, Yves Le" sort="Tulzo, Yves Le" uniqKey="Tulzo Y" first="Yves Le" last="Tulzo">Yves Le Tulzo</name></country><country name="Suisse"><noRegion><name sortKey="Richard, Jean Christophe Marie" sort="Richard, Jean Christophe Marie" uniqKey="Richard J" first="Jean-Christophe Marie" last="Richard">Jean-Christophe Marie Richard</name></noRegion><name sortKey="Brochard, Laurent" sort="Brochard, Laurent" uniqKey="Brochard L" first="Laurent" last="Brochard">Laurent Brochard</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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