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Early mobilization protocols for critically ill pediatric patients: systematic review

Taila Cristina Piva1, Renata Salatti Ferrari2, Camila Wohlgemuth Schaan2

  • 1Programa de Residência Integrada Multiprofissional em Saúde da Criança, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.

Revista Brasileira De Terapia Intensiva
|June 20, 2019
PubMed

Insights

Early mobilization protocols in pediatric intensive care units are individualized and multidisciplinary. Further research is needed to demonstrate the efficacy of these early mobilization interventions.

Area of Science:

  • Pediatric Intensive Care
  • Rehabilitation Medicine
  • Evidence-Based Practice

Background:

  • Early mobilization is crucial for critically ill children.
  • Existing protocols in pediatric intensive care units (PICUs) vary.
  • Standardized approaches are needed to optimize patient outcomes.

Purpose of the Study:

  • To systematically review and describe current early mobilization protocols in PICUs.
  • To identify common elements, interventions, and challenges in pediatric early mobilization.
  • To inform the development of evidence-based mobilization strategies for critically ill children.

Main Methods:

  • Systematic literature review of multiple databases (MEDLINE, Embase, SciELO, LILACS, PeDRO).
  • Inclusion of observational studies and clinical trials (randomized and non-randomized) of patients aged 29 days to 18 years.
  • Quality assessment using established tools (Newcastle-Ottawa Scale, Methodological Index for Non-Randomized Studies, Cochrane Collaboration).

Main Results:

  • Six studies were included from 8,663 identified.
  • Protocols involved progressive passive mobilization, positioning, goal setting, and clear contraindications.
  • Cycle ergometers and virtual reality were noted as mobilization resources.
  • Multidisciplinary team involvement was highlighted in four studies.

Conclusions:

  • Early mobilization protocols are generally individualized based on child development.
  • Cycle ergometer use appears feasible and safe for pediatric intensive care patients.
  • Institutional and multidisciplinary protocols can enhance early mobilization adoption, but efficacy studies are required.
Abstract

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