Physical and occupational therapy utilization in a pediatric intensive care unit

Area of Science:

• Pediatric critical care medicine
• Rehabilitation medicine

Background:

• Physical therapy (PT) and occupational therapy (OT) are crucial for recovery in critically ill patients.
• Understanding the utilization and impact of PT and OT in the pediatric intensive care unit (PICU) is essential for optimizing patient outcomes.

Purpose of the Study:

• To characterize the utilization patterns of PT and OT consultations within a pediatric intensive care unit (PICU).
• To identify factors associated with receiving PT and OT services and their impact on outcomes in critically ill children.

Main Methods:

• A retrospective study of 138 children (aged 1 week-18 years) admitted to a tertiary care PICU for ≥3 days.
• Data collected included patient characteristics, PT/OT session details, and adverse events.
• Multivariable logistic regression and propensity analysis were used to determine factors associated with consultation and outcomes.

Main Results:

• Only 29% (40/138) of children received PT and OT consultations, with services initiated an average of 6.9 days post-admission.
• Range of motion exercises (83%) were most common; 28% of patients were ambulated.
• Children receiving PT/OT were older, more likely to need neuromuscular blockers, and had lower pre-PICU POPC scores.

Conclusions:

• Rehabilitative therapies like PT and OT are underutilized in the PICU setting.
• More research is needed to establish the efficacy of early PT and OT interventions for improving outcomes in critically ill children.