Early Mobilization in Pediatric Critical Care: Exploring the Gap Between Theory and Practice in Saudi Arabia

Med Sci Monit. 2024 Mar 2:30:e942467. doi: 10.12659/MSM.942467.

Abstract

BACKGROUND Because of advancements in critical care, Pediatric Intensive Care Units (PICUs) have experienced improved survival rates. However, PICU-acquired frailty and cognitive deficits continue to be issues. In PICUs, early mobilization is emerging as a useful technique. The present study assesses early mobilization awareness, opinions, and practices among pediatric critical care providers in Saudi Arabia. MATERIAL AND METHODS From July 2020 to February 2021, a survey was undertaken in Saudi Arabia, targeting 110 physicians, 200 nurses, 30 respiratory therapists, and 20 physiotherapists. It concentrated on emergency medicine practices, operational issues, initiation time, rehabilitation modalities, and PICU staff strain. RESULTS The results showed that 64.7% of the 266 respondents were nurses, usually working in 5- to 15-bed ICUs providing medical and surgical treatment. Early mobilization was evaluated as highly significant by 40.6% of the respondents. Equipment constraints (63.5%), patient medical instability (67.3%), endotracheal intubation complications (65.4%), and personnel limits (56.4%) were major challenges. Non-physicians cited space constraints 38.9% of the time, whereas physicians cited safety concerns 47.4% of the time. Respiratory physiotherapy and passive range-of-motion exercises were the most used rehabilitation techniques (77.8%). Only 38.7% of patients with ICU-acquired weakness were referred for outpatient therapy. CONCLUSIONS The study emphasizes the importance of early mobilization in Saudi Arabian pediatric critical care while also recognizing considerable limitations. Addressing these difficulties necessitates a multidisciplinary, strategic approach. Future research should strive to standardize practices to enhance patient outcomes and develop standards in pediatric critical care.

MeSH terms

  • Child
  • Critical Care / methods
  • Early Ambulation* / methods
  • Humans
  • Intensive Care Units, Pediatric
  • Physicians* / psychology
  • Saudi Arabia