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Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units.
Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours.
Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events.
Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.
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http://dx.doi.org/10.5935/2965-2774.20230388-en | DOI Listing |
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
Pediatr Investig
December 2024
Division of Neonatology, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA.
Importance: Objective measures of lung function are critical for assessing respiratory outcomes of prematurity. Among extremely low gestational age neonates (ELGANs) (< 29 weeks gestational age), high rates of neurodevelopmental impairment may interfere with lung function testing. Impulse oscillometry (IOS) is a noninvasive test of respiratory system mechanics not requiring forced expiration.
View Article and Find Full Text PDFPatient Educ Couns
December 2024
Department of Pediatrics and Neonatology, OLVG, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, the Netherlands.
Objective: To examine the effects of clinicians' provision of (un)reasonable arguments on parent-related outcomes in neonatal (intensive) care (NICU), starting from the NICU Communication Framework.
Methods: A video-vignette experiment, in which we systematically varied clinicians' use of (reasonable, unreasonable, no) argumentation across two non-acute and two acute decision-making scenarios (3×4 design). Reasonable arguments were medically appropriate and constructive reasons to support the treatment plan, as defined by an expert panel.
Objective: Delays in discharges have a downstream effect on emergency department admissions, wait times, intensive care unit transfers, and elective admissions. This quality improvement project's aim was to increase the percentage of discharges before noon from a hospital medicine service from 19% to 30% over a 6-month period and sustain the increase for 6 months.
Methods: Interventions included introduction of a dedicated patient flow provider (PFP), optimization of workflow, technology assistance with discharge tasks, and multidisciplinary education on patient flow.
Am J Perinatol
December 2024
Department of Obstetrics and Gynecology, Jersey City Medical Center, West New York, New Jersey.
The Diabetes in Pregnancy Program Project Grant (PPG) was a 15-year program focused on enhancing the care for women with insulin-dependent diabetes mellitus (IDDM) during pregnancy and improving the well-being of their offspring. Launched in July 1978 at the University of Cincinnati, the PPG pursued a multifaceted research agenda encompassing basic science, animal and placental studies, and maternal and neonatal clinical trials to understand the physiological and pathophysiological aspects of IDDM during pregnancy. A total of 402 singleton pregnancies in 259 women with IDDM were enrolled prior to 10 weeks gestation over the 15-year period.
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