Evidence map›Paper›PMID 32576273›Full record

ArticleCritical care (London, England)2020

Mobilization practices in critically ill children: a European point prevalence study (EU PARK-PICU).

Erwin Ista, Barnaby R Scholefield, Joseph C Manning, Irene Harth, Orsola Gawronski, Alicja Bartkowska-Śniatkowska, Anne-Sylvie Ramelet, Sapna R Kudchadkar, EU PARK-PICU Collaborators

Registry-linked trialOpen access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04989790 (Clinical Effectiveness of the "PICU Up!" Multifaceted Early Mobility Intervention for Critically Ill Children), which is not on this map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
4.3field-weighted citation impact, top 5% of its field
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.

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

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.

  1. Pooled it
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  8. Provision of physiotherapy services for children in intensive care units in Uganda: A descriptive study.The Southern African journal of critical care : the official journal of the Critical Care Society · 2026
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  13. Early Mobilization in Pediatric Critical Care: Exploring the Gap Between Theory and Practice in Saudi Arabia.Medical science monitor : international medical journal of experimental and clinical research · 2024
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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

9 authors at 20 institutions in 14 countries.

Erwin IstaPediatric Intensive Care Unit, Department of Paediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands. w.ista@erasmusmc.nl.ORCID 0000-0003-1257-3108
Barnaby R ScholefieldBirmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Joseph C ManningNottingham Children's Hospital & Neonatology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Irene HarthPediatric Intensive Care Unit, Universitätsmedizin Mainz, Zentrum für Kinder- und Jugendmedizin, Mainz, Germany.
Orsola GawronskiHealthcare professional development Unit, Bambino Gesù Children's Hospital, Rome, Italy.
Alicja Bartkowska-ŚniatkowskaDepartment of Pediatric Anesthesiology and Intensive Therapy, Poznań University of Medical Sciences, Poznań, Poland.
Anne-Sylvie RameletInstitute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.
Sapna R KudchadkarDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
EU PARK-PICU Collaborators
Bambino Gesù Children's Hospital · ITDokuz Eylül University · TRNottingham University Hospitals NHS Trust · GBPoznan University of Medical Sciences · PLAlder Hey Children's NHS Foundation Trust · GBBristol Royal Hospital for Children · GBCopenhagen University Hospital · DKGreat Ormond Street Hospital · GBKlinik und Poliklinik für Kinder- und Jugendmedizin · DEOspedale Maggiore · ITRadboud University Nijmegen · NLRoyal Stoke University Hospital · GBUniversity Medical Center Groningen · NLAsklepios Klinik Sankt Augustin · DEBirmingham Women's Hospital · GBEmma Kinderziekenhuis · NLErasmus MC · NLIstituto Giannina Gaslini · ITJohannes Gutenberg University Mainz · DEJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly mobilization of adults receiving intensive care improves health outcomes, yet little is known about mobilization practices in paediatric intensive care units (PICUs). We aimed to determine the prevalence of and factors associated with physical rehabilitation in PICUs across Europe.

methodsA 2-day, cross-sectional, multicentre point prevalence study was conducted in May and November 2018. The primary outcome was the prevalence of physical therapy (PT)- or occupational therapy (OT)-provided mobility. Clinical data and data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥72 h.

resultsData of 456 children admitted to one of 38 participating PICUs from 15 European countries were collected (456 patient days); 70% were under 3 years of age. The point prevalence of PT- and/or OT-provided mobility activities was 39% (179/456) (95% CI 34.7-43.9%) during the patient days, with significant differences between European regions. Nurses were involved in 72% (924/1283) of the mobility events; in the remaining 28%, PT/OT, physicians, family members, or other professionals were involved. Of the factors studied, family presence was most strongly positively associated with out-of-bed mobilization (aOR 7.83, 95% CI 3.09-19.79). Invasive mechanical ventilation with an endotracheal tube was negatively associated with out-of-bed mobility (aOR 0.28, 95% CI 0.12-0.68). Patients were completely immobile on 25% (115/456) of patient days. Barriers to mobilization were reported on 38% of patient days. The most common reported patient-related barriers were cardiovascular instability (n = 47, 10%), oversedation (n = 39, 9%), and medical contraindication (n = 37, 8%). Potential safety events occurred in 6% of all documented mobilization events.

conclusionTherapists are infrequently consulted for mobilization of critically ill children in European PICUs. This study highlights the need for a systematic and interdisciplinary mobilization approach for critically ill children.

Indexed as

ChildChild, PreschoolCritical IllnessCross-Sectional StudiesEarly AmbulationEuropeFemaleHumansInfantInfant, NewbornIntensive Care Units, PediatricMaleOdds RatioPrevalenceTime FactorsCritical careDevelopmental paediatricsIntensive care unitsOccupational therapyPaediatricsPhysical therapyRehabilitation

Identifiers

PMID32576273
PMCPMC7311184
OpenAlexW3036094937

What OpenQuestion holds

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LicenceCC BY
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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.