Feasibility and Safety of Early Mobilization in Critically Ill Children: A Prospective Observational Study

Abstract The study aims to evaluate the feasibility and the safety of early mobilization in critically ill children under 2 years and its impact on comfort scores. This prospective, monocenter clinical trial was conducted in a tertiary care pediatric intensive care unit in Belgium. Twenty children were recruited to the study. Early mobilization was done between 24 and 48 hours of admission. Mobilization of upper and lower limbs was performed according to practice protocol. The heart rate (HR), respiratory rate (RR), systolic and diastolic blood pressures (SBP and DBP, respectively) and pulsed oxygen saturation were recorded before mobilization, immediately after the treatment and after 10, 30 and 60 minutes. The EDIN score for the extubated children and the COMFORT-B score for the intubated children were used in order to evaluate comfort. The primary outcome was the feasibility and safety of early mobilization. The secondary outcome was to evaluate the impact of early mobilization on comfort. Sixteen sessions were completed and 4 sessions of mobilization were interrupted because of important agitation. HR, SBP and DPB showed no change immediately after the mobilization, compared with baseline. RR and SpO2 were similar at the different times. Agitation had impact on the EDIN and COMFORT-B scores in children whose session was interrupted. No adverse events were reported.Conclusions: Early mobilization is feasible and safe in the majority of critically ill children under 2 years even if the agitation is described as an adverse event. Early mobilization does not influence the cardio-respiratory parameters.Clinical Trial Registration number and date of registration: Clinicaltrials.gov, NCT02958124, 10/09/2017