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

Norihiko Tsuboi
1   Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Hitomi Nozaki
2   Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Yukihiro Ishida
2   Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Ikue Kanazawa
2   Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Miku Inamoto
1   Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Kenichiro Hayashi
1   Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Nao Nishimura
1   Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Satoshi Nakagawa
1   Department of Critical Care Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Mureo Kasahara
3   Organ Transplantation Center, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
,
Takeshi Kamikubo
2   Department of Rehabilitation, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

24 April 2016

18 August 2016

Publication Date:
21 September 2016 (online)

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.

Note

The authors Norihiko Tsuboi and Mureo Kasahara have received the grant from National Center for Child Health and Development (no. 27–1). For the remaining authors none were declared.


 
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