Evidence map›Paper›PMID 36918956›Full record

ArticleTrials2023

Impact of a multifaceted early mobility intervention for critically ill children - the PICU Up! trial: study protocol for a multicenter stepped-wedge cluster randomized controlled trial.

Razvan Azamfirei, Colleen Mennie, Victor D Dinglas, Arooj Fatima, Elizabeth Colantuoni, Ayse P Gurses, Michele C Balas, Dale M Needham, Sapna R Kudchadkar, on behalf of the PICU Up! Investigators

Registry-linked trialOpen access · goldFull text readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2023. 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 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.1field-weighted citation impact, top 13% 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 map

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

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Review
  3. 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

10 authors at 2 institutions in 2 countries.

Razvan AzamfireiDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-3301-0566
Colleen MennieDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Victor D DinglasDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Arooj FatimaDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Elizabeth ColantuoniOutcomes after Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA.
Ayse P GursesDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Michele C BalasCollege of Nursing, University of Nebraska Medical Center, Omaha, NE, USA.
Dale M NeedhamDivision of Pulmonary and Critical Care Medicine, 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. sapna@jhmi.edu.
on behalf of the PICU Up! Investigators
Johns Hopkins University · USUniversity of Nebraska Medical Center · US

Funding

Clinical Effectiveness of the "PICU Up!" Multifaceted Early Mobility Intervention for Critically Ill Children: A pragmatic, stepped-wedge trialR01HD103811 · NICHD · JOHNS HOPKINS UNIVERSITY · PI KUDCHADKAR, SAPNA R · 2021 to 2025
$3.1M
Protein Optimization with Exercise to Improve Muscle Mass and Functional Outcomes (PROXIMUS)R01DK132348 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI KUDCHADKAR, SAPNA R, MEHTA, NILESH M · 2022 to 2024
$1.0M
NICHD NIH HHS R01 HD103811NIDDK NIH HHS R01 DK132348
6 · The paper itself

Abstract

backgroundOver 50% of all critically ill children develop preventable intensive care unit-acquired morbidity. Early and progressive mobility is associated with improved outcomes in critically ill adults including shortened duration of mechanical ventilation and improved muscle strength. However, the clinical effectiveness of early and progressive mobility in the pediatric intensive care unit has never been rigorously studied. The objective of the study is to evaluate if the PICU Up! intervention, delivered in real-world conditions, decreases mechanical ventilation duration (primary outcome) and improves delirium and functional status compared to usual care in critically ill children. Additionally, the study aims to identify factors associated with reliable PICU Up! delivery.

methodsThe PICU Up! trial is a stepped-wedge, cluster-randomized trial of a pragmatic, interprofessional, and multifaceted early mobility intervention (PICU Up!) conducted in 10 pediatric intensive care units (PICUs). The trial's primary outcome is days alive free of mechanical ventilation (through day 21). Secondary outcomes include days alive and delirium- and coma-free (ADCF), days alive and coma-free (ACF), days alive, as well as functional status at the earlier of PICU discharge or day 21. Over a 2-year period, data will be collected on 1,440 PICU patients. The study includes an embedded process evaluation to identify factors associated with reliable PICU Up! delivery. DISCUSSION: This study will examine whether a multifaceted strategy to optimize early mobility affects the duration of mechanical ventilation, delirium incidence, and functional outcomes in critically ill children. This study will provide new and important evidence on ways to optimize short and long-term outcomes for pediatric patients.

trial registrationClinicalTrials.gov NCT04989790. Registered on August 4, 2021.

Indexed as

Critical IllnessDeliriumAdultChildHumansIntensive Care Units, PediatricMulticenter Studies as TopicPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicRespiration, ArtificialTreatment OutcomeCluster randomized controlled trialCritical careIntensive care unitPediatricsRehabilitation

Identifiers

PMID36918956
PMCPMC10015670
OpenAlexW4324311368

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read11
Read underepoch 390

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.