Physical rehabilitation in Brazilian pediatric intensive care units: a multicenter point prevalence study

Area of Science:

• Pediatric critical care medicine
• Rehabilitation therapy
• Public health research

Background:

• Physical rehabilitation is crucial for critically ill children in pediatric intensive care units (PICUs).
• Understanding the prevalence and factors influencing rehabilitation is essential for improving patient outcomes.
• Previous research has highlighted variations in rehabilitation practices globally.

Purpose of the Study:

• To determine the prevalence of physical rehabilitation for critically ill children in Brazilian PICUs.
• To identify factors associated with the provision of mobility interventions.
• To assess barriers and safety events related to mobilization.

Main Methods:

• A 2-day, cross-sectional, multicenter point prevalence study was conducted in 27 Brazilian PICUs.
• Data were collected on patient mobility, safety events, and mobilization barriers for patients admitted for ≥72 hours.
• The study was part of the multinational Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU) initiative.

Main Results:

• Therapist-provided mobility occurred in 74% of patient-days.
• Children under 3 years comprised 68% of the population.
• Out-of-bed mobility was positively associated with family presence (aOR 3.31) and negatively with arterial lines (aOR 0.16).
• Mobilization barriers were reported in 27% of patient-days, most commonly due to lack of physician order.
• Potential safety events occurred in 3% of mobilization events.

Conclusions:

• Therapist-provided mobility is frequent in Brazilian PICUs.
• Family presence is a significant positive factor for out-of-bed mobility.
• Continuous availability of physiotherapists may substantially improve mobilization of critically ill children.