Tsuboi Norihiko, Nozaki Hitomi, Ishida Yukihiro, Kanazawa Ikue, Inamoto Miku, Hayashi Kenichiro, Nishimura Nao, Nakagawa Satoshi, Kasahara Mureo, Kamikubo Takeshi
Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan.
Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan.
J Pediatr Intensive Care. 2017 Sep;6(3):199-205. doi: 10.1055/s-0036-1593387. Epub 2016 Sep 21.
This study aims to evaluate the impact of early mobilization (EM) after pediatric liver transplantation in the pediatric intensive care unit (PICU). A 14-month prospective before and after study. Multivalent PICU with 20 beds at a tertiary children's hospital. A total of 57 patients aged younger than 16 years who received liver transplantation and were admitted to the PICU after surgery. EM project, a multifaceted framework for successful EM practice in the PICU focusing on a multidisciplinary team approach. 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%, < 0.001). Also, there were greater median numbers of physical therapy per eligible patient (0 vs. 3, < 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. 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.
本研究旨在评估小儿重症监护病房（PICU）中儿童肝移植后早期活动（EM）的影响。
一项为期14个月的前瞻性前后对照研究。
一家拥有20张床位的三级儿童医院的多用途PICU。
共有57例16岁以下接受肝移植并术后入住PICU的患者。
EM项目，一个在PICU成功实施EM实践的多方面框架，侧重于多学科团队方法。
与EM项目实施前相比，PICU中接受物理治疗的患者比例显著增加（43%对97%，P<0.001）。此外，每位符合条件的患者接受物理治疗的中位数也更多（0次对3次，P<0.001）。而且，患者在更短的时间内达到了更高的功能活动水平。插管时间、PICU住院时间和住院总时长无显著差异。未发生不良事件或死亡。
采用EM项目流程后，肝移植后接受物理治疗的患者比例增加。然而，PICU住院时间或住院总时长并无差异。我们的研究结果表明，接受肝移植的小儿患者对早期活动耐受良好且安全。
