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Transforming Mobility in the Pediatric ICU



Traditionally, clinicians keep children in critical condition in the pediatric intensive care unit (PICU) constrained to their beds. However, extended periods of immobilization in ICUs have been associated with various impairments of physical functioning and neuromuscular weakness, which can occur in 25% to 50% of ICU patients. Furthermore, pediatric patient immobilization can have adverse effects on the mental and emotional well-being of the patient and the patient’s family.

Fortunately, studies have shown that early mobilization can significantly reduce the negative physical effects of intensive care unit stays in adult and children populations. Early mobilization has also been linked to decreased length of stay in the intensive care unit. Since the average cost of treatment in the PICU can exceed $9,000 per day at many hospitals, early pediatric mobilization can lead to a notable reduction of healthcare costs. Additionally, research shows that early mobilization is generally safe and feasible for adults with the right equipment. Data collected from the Johns Hopkins PICU corroborates these results and found that there was a 0% adverse event rate across 200 cases of early pediatric mobilization. Although early pediatric mobilization is safe and has numerous proven benefits, no pediatric-specific walking equipment exists to help children achieve early mobilization. This is likely due to the large height and weight variability among pediatrics. Among the 53 institutions participating in the PICU-Up early pediatric mobilization program, none posses equipment to assist in early mobilization for pediatrics. This is highly unfortunate, considering that approximately 250,000 children are admitted to PICUs each year. Two major obstacles that must be addressed to allow for wider PICU mobilization are that critically ill children often have multiple assistive technologies and monitoring devices that must be tethered to them, which makes it difficult to transport the patient, and that children can vary greatly in height. Dr. Kudchadkar would like for us to develop adjustable equipment that would allow for critically ill patients between the ages of 6 and 12 to walk around the intensive care unit, while effectively managing their attached assistive and monitoring equipment.

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