Early mobilization in the pediatric intensive care unit

Early mobilization, also referred to as early rehabilitation, in intensive care units (ICUs) has demonstrated efficacy in reducing hospital length of stay, duration of mechanical ventilation, and the incidence of delirium, as well as in enhancing functional recovery in adult critically ill patients.However, in pediatric intensive care units (PICUs), the clinical application of this approach remains comparatively limited compared with adults due to several constraining factors.These include wide variability in developmental stages and ages, the presence of severe disabilities related to underlying conditions, and limited availability of specialized equipment and trained staff.In critically ill pediatric patients, prolonged bed rest has been shown to contribute to post-intensive care syndrome in pediatrics, which may manifest as functional decline, muscle weakness, developmental delays, and social health problems.Early rehabilitation initiated within 24-72 hours of PICU admission has been associated with improvements in muscle function, physical performance, and post-discharge quality of life.Although the current evidence base supporting early rehabilitation in pediatric critically ill patients remains low in quality, an increasing number of clinical trials have reported favorable outcomes, including reduced delirium and shorter hospital stays, suggesting that the strength of evidence will continue to improve.Future research should evaluate the current status of early rehabilitation practices in PICUs in Korea, identify systemic limitations, and determine areas requiring improvement.Accordingly, coordinated efforts will be needed to align medical reimbursement with the resources and multidisciplinary workforce required to overcome existing barriers.Furthermore, the development and implementation of PICU-specific early rehabilitation guidelines that incorporate developmental considerations and active family engagement are essential to optimizing functional outcomes in critically ill children.