Kristina A Betters1, Kiran B Hebbar2, David Farthing3, Brittany Griego3, Tricia Easley3, Hartley Turman3, Lauren Perrino3, Stephanie Sparacino3, Mary L deAlmeida2. 1. Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA 30322, United States; Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30322, United States. Electronic address: kristina.betters@vanderbilt.edu. 2. Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA 30322, United States; Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30322, United States. 3. Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA 30322, United States.
Abstract
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU. A quality database was used to prospectively monitor patient tolerance of EM sessions and for serious adverse events, defined as unplanned extubation, hemodynamic instability, loss of central venous line, loss of arterial line, displacement of ECMO cannula, or cardiopulmonary arrest. RESULTS: Between December 2013 and October 2016, 74 patients received EM for a total of 130 unique sessions. No serious adverse events occurred. Two patients had an oxygen desaturation episode during mobility that resolved with ventilator modifications, and one patient had nasogastric tube displacement during mobility. CONCLUSIONS: Early mobility is attainable in a quaternary care PICU population without serious adverse events, using a multidisciplinary approach and appropriate staff education. Further research is needed to understand the physical and neurocognitive benefits of EM in children.
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU. A quality database was used to prospectively monitor patient tolerance of EM sessions and for serious adverse events, defined as unplanned extubation, hemodynamic instability, loss of central venous line, loss of arterial line, displacement of ECMO cannula, or cardiopulmonary arrest. RESULTS: Between December 2013 and October 2016, 74 patients received EM for a total of 130 unique sessions. No serious adverse events occurred. Two patients had an oxygen desaturation episode during mobility that resolved with ventilator modifications, and one patient had nasogastric tube displacement during mobility. CONCLUSIONS: Early mobility is attainable in a quaternary care PICU population without serious adverse events, using a multidisciplinary approach and appropriate staff education. Further research is needed to understand the physical and neurocognitive benefits of EM in children.
Authors: Ruchit V Patel; Juliana Redivo; Archana Nelliot; Michelle N Eakin; Beth Wieczorek; Julie Quinn; Ayse P Gurses; Michele C Balas; Dale M Needham; Sapna R Kudchadkar Journal: Pediatr Crit Care Med Date: 2021-04-01 Impact factor: 3.971
Authors: Stefanie G Ames; Lauren J Alessi; Maddie Chrisman; Meg Stanger; Devin Corboy; Amit Sinha; Ericka L Fink Journal: Pediatr Qual Saf Date: 2021-05-19