« Ce que les pédiatres peuvent nous apprendre »

Environment and practices in neonatal intensive care units have been modified to increase infants' comfort but also to optimize brain development and the attachment process. Environmental strategies (control of light and noise levels, single rooms) seem replicable in adult units. Behavioural strategies are specific to the neonatal period, except the sleep protection. The patient- and family-centered care philosophy, based on dignity and respect, information sharing, participation and collaboration, seems universal and applicable in intensive care units. Some patient-centered programs, such as NIDCAP for the preterm neonate, very close to the HELP for the elderly, combine the environmental and behavioural strategies. Significant differences in routine practices are observed among countries, with a north-south gap in Europe. Evaluation of these practices using randomized trials is difficult and may require the use of qualitative research and/or benchmarking.