• Journal of critical care · Oct 2017

    Development and implementation of an early mobility program for mechanically ventilated pediatric patients.

    • Kristina A Betters, Kiran B Hebbar, David Farthing, Brittany Griego, Tricia Easley, Hartley Turman, Lauren Perrino, Stephanie Sparacino, and Mary L deAlmeida.
    • 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.
    • J Crit Care. 2017 Oct 1; 41: 303-308.

    PurposeEarly 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.MethodsA 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.ResultsBetween 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.ConclusionsEarly 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.Copyright © 2017 Elsevier Inc. All rights reserved.

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