Evidence map›Paper›PMID 29357778›Full record

ArticleJournal of intensive care medicine2020

Normal Baseline Function Is Associated With Delayed Rehabilitation in Critically Ill Children.

Shinya Miura, Beth Wieczorek, Hallie Lenker, Sapna R Kudchadkar

2 registry-linked trialsAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03860168 naactive not recruitingnot on this map

PICU Up!:A Pilot Stepped-wedge Trial of a Multicomponent Early Mobility Intervention for Critically Ill Children

TypeinterventionalSponsorJohns Hopkins UniversityRan2019 to 2026Enrolled2,500ConditionsCritical IllnessArmsPICU Up!
NCT04989790 narecruitingnot on this mapstarted 2022, after this paper: background citation

Clinical Effectiveness of the "PICU Up!" Multifaceted Early Mobility Intervention for Critically Ill Children: A Pragmatic, Stepped-wedge Trial

TypeinterventionalSponsorJohns Hopkins UniversityRan2022 to 2026Enrolled1,440ConditionsChild, Intensive Care Unit Acquired Weakness, Critical Illness, Hospital Acquired Pressure UlcerArmsPICU Up!
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Shinya MiuraDepartment of Pediatric Intensive Care, Saitama Children's Medical Center, Saitama, Japan.
Beth WieczorekDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Hallie LenkerDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sapna R KudchadkarDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Funding

QAQC Johns Hopkins Institute for Clinical and Translational ResearchUL1TR003098 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2019 to 2023
$57.7M
Institute for Clinical and Translational Research (KL2)KL2RR025006 · NCRR · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2007 to 2011
$12.9M
NCATS NIH HHS UL1 TR003098NCRR NIH HHS KL2 RR025006
6 · The paper itself

Abstract

backgroundEarly mobilization of patients in the adult intensive care unit (ICU) is associated with improved functional outcomes and shorter ICU stay. Although emerging evidence suggests that early mobilization in pediatric ICUs (PICUs) is safe and feasible, physical therapist (PT) consultation may be delayed because of perceptions that patient acuity precludes mobilization activities. Factors that influence timely involvement of PTs to facilitate acute rehabilitation in critically ill children have not been characterized. The aim of this study was to identify patient-level factors for early PT consultation in a tertiary care PICU before large-scale implementation of a multicomponent early mobilization program.

methodsWe conducted a retrospective analysis of data from the PICU Up! Quality Improvement Initiative. The primary outcome was early rehabilitation, defined as PT consultation within the first 3 days of PICU admission. Patients (n = 100) were divided into 2 groups by outcome, and predictive factors for early rehabilitation were analyzed with logistic regression.

resultsOf 100 children, 54% received early rehabilitation. In univariate analyses, higher pediatric risk of mortality (PRISM) score (

conclusionsCritically ill children with normal baseline function or lower acuity of illness are less likely to have initiation of early rehabilitation with PT prior to implementation of a unit-wide early mobilization program. Baseline motor impairment and higher PRISM scores were independently associated with early rehabilitation. These findings highlight the need for streamlined criteria for PT consultation to meet the rehabilitation needs of all critically ill patients.

Indexed as

Patient AcuityAdolescentChildChild, PreschoolCritical CareCritical IllnessEarly AmbulationFemaleHealth Plan ImplementationHumansInfantInfant, NewbornIntensive Care Units, PediatricLogistic ModelsMalePhysical Therapy Modalitieschildcritical careearly mobilizationpediatricspostoperative carepostoperative complicationsprogram developmentrisk factor

Identifiers

PMID29357778
PMCPMC7288243

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.