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Multicenter Study
. 2023 Dec 22;35(3):290-301.
doi: 10.5935/2965-2774.20230388-en. eCollection 2023.

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

[Article in English, Portuguese]
Juliana Redivo  1 , Harini Kannan  1 , Andreia Aparecida Freitas Souza  2 , José Colleti Junior  3 , Sapna Ravi Kudchadkar  4 ; Acute Rehabilitation for Kids in the PICU (PARK-PICU) Investigators; Nelson Kazunobu Horigoshi  5 , Graziela de Araújo Costa  6 , Taísa Roberta Ramos de Castilho  7   8 , Paula Peres Domingues Peron  9 , Walter Perez Scaranto  10 , Daniela Nasu Monteiro Medeiros  11 , Toshio Matsumoto  12 , Carlos Gustavo de Almeida  13 , Felipe Rezende Caino de Oliveira  14 , Marcelo Barciela Brandão  15 , Fernanda Lima-Setta  16 , Arnaldo Prata-Barbosa  17   18   19   20   21   22 , Glaciele Nascimento Xavier  23 , Livia Barbosa de Andrade  24 , Agda Ultra de Aguiar  25 , Marcos Paulo Galdino Coutinho  26 , Roberta Esteves Viera de Castro  27 , Glazia André Landy  28 , Suzana Lopes Bonfim Balaniuc  29 , Ricardo Silveira Yamaguchi  30
Affiliations
Multicenter Study

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

[Article in English, Portuguese]
Juliana Redivo et al. Crit Care Sci. .

Abstract

Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units.

Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours.

Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events.

Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Number of activities by clinician type.
Figure 2
Figure 2
Highest level of mobility.
Figure 3
Figure 3
Mobilization barriers (375 patient days).
See this image and copyright information in PMC

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