Please use this identifier to cite or link to this item: 10.1186/s13054-020-02988-2
Title: Mobilization practices in critically ill children : A European point prevalence study (EU PARK-PICU)
Authors: Ista, Erwin
EU PARK-PICU
Balmaks, Reinis
Keywords: Critical care;Developmental paediatrics;Intensive care units;Occupational therapy;Paediatrics;Physical therapy;Rehabilitation;3.2 Clinical medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database;Critical Care and Intensive Care Medicine
Issue Date: 24-Jun-2020
Citation: Ista , E , EU PARK-PICU & Balmaks , R 2020 , ' Mobilization practices in critically ill children : A European point prevalence study (EU PARK-PICU) ' , Critical Care , vol. 24 , no. 1 , 368 , pp. 368 . https://doi.org/10.1186/s13054-020-02988-2
Abstract: BACKGROUND: Early mobilization of adults receiving intensive care improves health outcomes, yet little is known about mobilization practices in paediatric intensive care units (PICUs). We aimed to determine the prevalence of and factors associated with physical rehabilitation in PICUs across Europe. METHODS: A 2-day, cross-sectional, multicentre point prevalence study was conducted in May and November 2018. The primary outcome was the prevalence of physical therapy (PT)- or occupational therapy (OT)-provided mobility. Clinical data and data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥72 h. RESULTS: Data of 456 children admitted to one of 38 participating PICUs from 15 European countries were collected (456 patient days); 70% were under 3 years of age. The point prevalence of PT- and/or OT-provided mobility activities was 39% (179/456) (95% CI 34.7-43.9%) during the patient days, with significant differences between European regions. Nurses were involved in 72% (924/1283) of the mobility events; in the remaining 28%, PT/OT, physicians, family members, or other professionals were involved. Of the factors studied, family presence was most strongly positively associated with out-of-bed mobilization (aOR 7.83, 95% CI 3.09-19.79). Invasive mechanical ventilation with an endotracheal tube was negatively associated with out-of-bed mobility (aOR 0.28, 95% CI 0.12-0.68). Patients were completely immobile on 25% (115/456) of patient days. Barriers to mobilization were reported on 38% of patient days. The most common reported patient-related barriers were cardiovascular instability (n = 47, 10%), oversedation (n = 39, 9%), and medical contraindication (n = 37, 8%). Potential safety events occurred in 6% of all documented mobilization events. CONCLUSION: Therapists are infrequently consulted for mobilization of critically ill children in European PICUs. This study highlights the need for a systematic and interdisciplinary mobilization approach for critically ill children.
Description: Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
DOI: 10.1186/s13054-020-02988-2
ISSN: 1364-8535
Appears in Collections:Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure

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