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Critical care nurse · Dec 2019
Early Mobilization of Infants Intubated for Acute Respiratory Failure.
- Laura Ortmann and Anne Dey.
- Laura Ortmann is an assistant professor of pediatrics and Anne Dey is the Director of Pediatric Critical Care at Children's Hospital and Medical Center Omaha, Omaha, Nebraska.
- Crit Care Nurse. 2019 Dec 1; 39 (6): 47-52.
BackgroundEarly mobility in the intensive care unit is being promoted as a way to improve outcomes but has not been studied in young infants.ObjectiveTo determine the safety of a holding intervention for infants intubated for respiratory failure.MethodsInfants less than 6 months of age intubated for respiratory failure underwent a holding intervention in which a caretaker held the infant at least twice a day once the infant was medically stabilized. Rates of adverse events were compared with historical controls matched by age and Pediatric Index of Mortality 2 score. Vital signs before and during holding were recorded to assess for physiologic tolerance.ResultsTwenty-four infants with a total of 158 holding interventions were studied. Mean holding duration was 99 minutes. Twenty holding interventions were terminated early, most commonly because of agitation. The 24 historical controls had 1 unplanned extubation and 2 arterial catheter removals. The intervention group had no unplanned extubations, inadvertent central catheter removals, or urinary catheter removals and had 1 arterial catheter removal that was not associated with holding. Vital signs before and during holding were similar. There were no differences between the control and intervention groups in duration of intubation (7.3 vs 6.0 days, P = .98), length of intensive care unit stay (9.1 vs 9.0 days, P = .52), or length of hospital stay (11.5 vs 12.5 days, P = .28).ConclusionsHolding intubated infants in the intensive care unit was well tolerated, without an increase in adverse events.©2019 American Association of Critical-Care Nurses.
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