Physical Functioning After Admission to the PICU: A Scoping Review

Area of Science:

• Pediatric critical care medicine
• Rehabilitation science
• Child health outcomes

Background:

• Pediatric intensive care unit (PICU) survivors often face long-term physical functioning deficits.
• Understanding the determinants and trajectory of physical functioning is essential for effective recovery.
• Current knowledge gaps hinder optimal assessment and intervention strategies.

Purpose of the Study:

• To conduct a scoping review on physical functioning in children during and after PICU admission.
• To identify measured domains of physical functioning and associated determinants.
• To synthesize existing knowledge and highlight clinical and research gaps.

Main Methods:

• Systematic literature search across major databases (PubMed, Embase, CINAHL, Cochrane).
• Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.
• Independent study screening, data extraction by two investigators, and narrative analysis.

Main Results:

• 68 studies included from 2,610 identified articles.
• PICU survivors report persistent physical functioning difficulties post-discharge, often below baseline.
• Longer hospital stay and comorbidities were associated with decreased physical functioning; mobility and self-care were primary domains assessed.

Conclusions:

• Children experience moderate to severe physical functioning difficulties during and years after PICU stay.
• Longitudinal assessments are recommended, particularly for high-risk children.
• A consensus on standardized methods for assessing physical functioning in PICU patients is needed.