Early mobilization in pediatric critical care and parental psychological outcomes 3-6 months after discharge-a pilot...

Advancements in care for critically ill children have lowered mortality but increased morbidity in survivors. Post-intensive care syndrome (PICS) in children including their families (PICS-p) underscores the need for interventions to mitigate long-term effects. Early mobilization shows promising results in adults; however, evidence in pediatrics is limited. Enhanced parental involvement may contribute to improved long-term psychological outcomes. This pilot study examines the impact of an early mobilization program on parental stress and psychological health after admission on a pediatric intensive care unit (PICU). This single-center pilot study was conducted between 2021 and 2024 at the PICU of the Radboudumc University Hospital. Data of parents of patients admitted before (n = 45) and after (n = 45) implementation of an early mobilization bundle (December 2022) were compared. Parental psychological health outcomes were assessed using validated post-traumatic stress disorder (PTSD), burden scales, anxiety, and depression questionnaires, completed within 3-6 months after admission. Ninety patients were enrolled. There was no significant difference between pre- and post-intervention groups, but a trend towards lower parental experienced distress score (2.2 (IQR 0-8) vs 4.0 (IQR0-9) p 0.08) and lower depression scores in fathers (8.5 (IQR 8-15) vs 9.5 (8-32), p 0.07) in the post-intervention group was observed.

Although no significant effect of early mobilization on parental psychological health was found, a trend towards a positive effect on the experienced distress scale and the paternal depression score emerged. A future nationwide study, on larger scale, is intended to further evaluate these findings.

• Early mobilization in adult critical care improves patient recovery and reduces ICU-acquired weakness and improves physical and psychological outcomes. • In the pediatric critical care setting, early mobilization is considered safe and feasible, but research on long-term effects is limited.

• This study focuses on the long-term effects of early mobilization on parental psychological health. • Findings indicate no significant difference between pre- and post-intervention group, but a positive trend of early mobilization on experienced distress scale and paternal depression score.