Early Mobilization in Pediatric Intensive Care Unit

ABSTRACTChildren admitted to the pediatric intensive care unit remain immobile for long periods of time for various reasons and struggle with permanent problems that affect life even after discharge. Due to these negative outcomes, rehabilitation and early mobilization of patients during the intensive care period have gained importance. Mobilization activities are carried out in a planned manner by creating an interdisciplinary, nurse-focused protocol with the cooperation of the physician, physiotherapist, pediatric occupational therapist and family. The early mobilization protocol is a gradual system in which the patient's sleep hygiene, pain, delirium and sedation are evaluated and individualized mobilization goals specific to the patient are determined. Various mobilization activities such as in-bed active and passive Range of motion exercises, sitting on the edge of the bed, throwing a ball, in-bed bicycle ergometry, and walking are planned according to the clinical condition and tolerance of the patient. In clinical studies, it has been reported that with the use of early mobilization protocol, the number of patients and mobilization activities increased, the length of hospital stay of patients decreased, daily living activities improved, and morbidities acquired in intensive care decreased. Nurses can easily integrate mobilization activities into daily care because they are with the patient all day. Current studies show that early mobilization activities are feasible and safe in critically ill pediatric patients. Furthermore, the lack of a standard mobilization protocol in pediatric intensive care units, lack of information, safety concerns, and inadequate equipment and personnel are barriers to the implementation of early mobilization. In this review, the definition and importance of early mobilization, examples of application in pediatric intensive care and the results of current clinical studies are discussed.