• Karen Choong, David J Zorko, Ronke Awojoodu, Laurence Ducharme-Crevier, Patricia S Fontela, Laurie A Lee, Anne-Marie Guerguerian, Garcia GuerraGonzaloGDepartment of Pediatrics, University of Alberta, Edmonton, AB, Canada., Kristina Krmpotic, Brianna McKelvie, Kusum Menon, Srinivas Murthy, Anupam Sehgal, Matthew J Weiss, and Sapna R Kudchadkar.
• Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
• Pediatr Crit Care Me. 2021 Feb 1; 22 (2): 181193181-193.

ObjectivesTo evaluate mobilization practices, barriers, and mobility-related adverse events in Canadian PICUs.DesignNational 2-day point prevalence study.SettingThirteen PICUs across Canada.PatientsChildren with a minimum 72-hour PICU length of stay on the allocated study day.InterventionsNone.Measurements And Main ResultsOutcomes 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%).ConclusionsMobilization 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.Copyright © 2020 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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