Mobilization practices in critically ill children: a European point prevalence study (EU PARK-PICU)

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Version: Final published version
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Serval ID
serval:BIB_E5B60A1DF478
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mobilization practices in critically ill children: a European point prevalence study (EU PARK-PICU)
Journal
Critical Care
Author(s)
Ista Erwin, Scholefield Barnaby R., Manning Joseph C., Harth Irene, Gawronski Orsola, Bartkowska-Śniatkowska Alicja, Ramelet Anne-Sylvie, Kudchadkar Sapna R.
Contributor(s)
Ritson P.C., Nikolaou F., de Neef M., Kneyber M., Penny-Thomas K., Linton C., Balmaks R., Richter M., Chiusolo F., Cecchetti C., Roberti M., Di Furia M., Grandjean C., Nygaard B., Lopez Y., Koroglu T., Besci T., Mora RDRD, Agbeko R.S., Borrows E., Bochaton N., Mattsson J., Ksellmann A., Hero B., Rosada-Kurasinska J., Świder M., Bonaldi A., Giugni C., Oruganti S., Gates S., Smith H., van Zwol A., Hills J., Conroy J., Bebbington M., Neunhoeffer F., Duval E.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
24
Number
1
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
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.
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.
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.
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.
Keywords
Critical Care and Intensive Care Medicine
Pubmed
Open Access
Yes
Create date
25/06/2020 13:46
Last modification date
23/07/2020 5:22
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