Early Mobilization after Pediatric Liver Transplantation

Norihiko Tsuboi; Hitomi Nozaki; Yukihiro Ishida; Ikue Kanazawa; Miku Inamoto; Kenichiro Hayashi; Nao Nishimura; Satoshi Nakagawa; Mureo Kasahara; Takeshi Kamikubo

doi:10.1055/s-0036-1593387

Journal of Pediatric Intensive Care, Inhaltsverzeichnis

J Pediatr Intensive Care 2017; 06(03): 199-205
DOI: 10.1055/s-0036-1593387

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Early Mobilization after Pediatric Liver Transplantation

Autor*innen

Norihiko Tsuboi

¹Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Hitomi Nozaki

²Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Yukihiro Ishida

²Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Ikue Kanazawa

²Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Miku Inamoto

¹Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Kenichiro Hayashi

¹Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Nao Nishimura

¹Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Satoshi Nakagawa

¹Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Mureo Kasahara

³Organ Transplantation Center, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
Takeshi Kamikubo

²Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan

Abstract

Objective This study aims to evaluate the impact of early mobilization (EM) after pediatric liver transplantation in the pediatric intensive care unit (PICU).

Design A 14-month prospective before and after study.

Setting Multivalent PICU with 20 beds at a tertiary children's hospital.

Patients A total of 57 patients aged younger than 16 years who received liver transplantation and were admitted to the PICU after surgery.

Interventions EM project, a multifaceted framework for successful EM practice in the PICU focusing on a multidisciplinary team approach.

Measurements and Main Results Compared with the period before the implementation of the EM project, there was a significant increase in the proportion of patients who received physical therapy in the PICU (43 vs. 97%, p < 0.001). Also, there were greater median numbers of physical therapy per eligible patient (0 vs. 3, p < 0.001). Moreover, patients achieved higher functional mobility level within a shorter time. Length of intubation, PICU stay, and hospital stay were not significantly different. There were no adverse events or deaths.

Conclusion Using an EM project process, the proportion of patients who received physical therapy after liver transplantation increased. However, there was no difference in the length of PICU or hospital stay. Our findings indicated that EM for pediatric patients who received liver transplantation was well tolerated and safe.

Keywords

early mobilization - rehabilitation - pediatric intensive care unit - physical therapy

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Referenzen

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