Prevalence of Acute Rehabilitation for Kids in the PICU: A Canadian Multicenter Point Prevalence Study*
| Autor: | Matthew J. Weiss, Kristina Krmpotic, Anupam Sehgal, Anne-Marie Guerguerian, Ronke Awojoodu, Laurence Ducharme-Crevier, Patricia S. Fontela, Srinivas Murthy, Brianna McKelvie, Kusum Menon, Sapna R. Kudchadkar, David J. Zorko, Gonzalo Garcia Guerra, Karen Choong, Laurie A. Lee |
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| Rok vydání: | 2020 |
| Předmět: |
Occupational therapy
Canada medicine.medical_specialty medicine.medical_treatment Psychological intervention Prevalence 030204 cardiovascular system & hematology Intensive Care Units Pediatric Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Vasoactive medicine Humans Child Adverse effect Early Ambulation Physical Therapy Modalities Rehabilitation Mobilization business.industry 030208 emergency & critical care medicine Odds ratio Pediatrics Perinatology and Child Health Emergency medicine business |
| Zdroj: | Pediatric Critical Care Medicine. 22:181-193 |
| ISSN: | 1529-7535 |
| DOI: | 10.1097/pcc.0000000000002601 |
| Popis: | Objectives To evaluate mobilization practices, barriers, and mobility-related adverse events in Canadian PICUs. Design National 2-day point prevalence study. Setting Thirteen PICUs across Canada. Patients Children with a minimum 72-hour PICU length of stay on the allocated study day. Interventions None. Measurements and main results Outcomes of interest were the prevalence and nature of mobilization activities, rehabilitation resources, adverse events, and factors associated with out-of-bed mobility and therapist-provided mobility. Two PICUs (15%) had early mobilization practice guidelines, and one PICU (8%) reported a formal process for engaging families in the mobilization of patients. The prevalence of mobilization was 110 of 137 patient-days (80%). The commonest activity was out-of-bed mobility (87/137; 64% patient-days); there was no active mobilization on 46 patient-days (34%). Therapists provided mobility on 33% of patient-days. Mobility was most commonly facilitated by nurses (74% events) and family (49% events). Family participation was strongly associated with out-of-bed mobility (odds ratio 6.4; p = 0.001). Intubated, mechanically ventilated patients were mobilized out-of-bed on 18 of 50 patient-days (36%). However, the presence of an endotracheal tube, vasoactive infusions, and age greater than or equal to 3 years were independently associated with not being mobilized out-of-bed. Barriers were reported on 58 of 137 patient-days (42%), and adverse events occurred in 22 of 387 mobility events (6%). Conclusions Mobilization is common and safe, and the majority of children in Canadian PICUs are being mobilized out-of-bed, even when mechanically ventilated. Family engagement in PICU-based rehabilitation is increasing. This study provides encouraging evidence that common barriers can be overcome in order to safely mobilize children in PICUs. |
| Databáze: | OpenAIRE |
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