In this World Shared Practice Forum podcast, Drs. Sapna Kudchadkar and Kate Madden discuss early mobilization programs in pediatric intensive care units (PICUs). They highlight the importance of interdisciplinary collaboration, including the need for shared mental frameworks regarding sedation practices and delirium screening and management. Dr. Kudchadkar describes the potential risks of delirium, the benefits of keeping patients oriented and engaged, and highlights the need for sustainability of early mobilization. She also discusses the implementation and challenges of the PICU UP! program.
LEARNING OBJECTIVES
Following this discussion, learners will be able to:
- Discuss the importance of early mobilization in PICU
- Explain the risks of delirium, as well as appropriate screening and management
- Identify the origins, goals, and benefits of the PICU Up! program
AUTHORS
Sapna Kudchadkar, MD, PhD, FCCM
Professor, Anesthesiologist-in-Chief of Johns Hopkins Children's Center, Vice Chair for Pediatric Anesthesiology and Critical Care Medicine, Director of the John Hopkins PICU Up! Program
Johns Hopkins University School of Medicine
Kate Madden, MD
Senior Associate, BCH Medical-Surgical ICU
Boston Children's Hospital
Assistant Professor of Anesthesiology
Harvard Medical School
DATE
Initial publication date: May 24, 2024.
ARTICLES REFERENCED
00:04:43 Wieczorek B, Ascenzi J, Kim Y, et al. PICU Up!: Impact of a Quality Improvement Intervention to Promote Early Mobilization in Critically Ill Children. Pediatr Crit Care Med. 2016;17(12):e559-e566. doi:10.1097/PCC.0000000000000983 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5138131/)
00:06:32 Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017;33(2):225-243. doi:10.1016/j.ccc.2016.12.005 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351776)
00:06:37 ICU liberation initiative (https://www.sccm.org/iculiberation)
00:33:24 Lin JC, Srivastava A, Malone S, et al. Caring for Critically Ill Children With the ICU Liberation Bundle (ABCDEF): Results of the Pediatric Collaborative. Pediatr Crit Care Med. 2023;24(8):636-651. doi:10.1097/PCC.0000000000003262 (https://pubmed.ncbi.nlm.nih.gov/37125798/)
00:34:32 Kudchadkar SR, Nelliot A, Awojoodu R, et al. Physical Rehabilitation in Critically Ill Children: A Multicenter Point Prevalence Study in the United States. Crit Care Med. 2020;48(5):634-644. doi:10.1097/CCM.0000000000004291 (https://pubmed.ncbi.nlm.nih.gov/32168030/)
00:39:40 X @SapnaKMD (https://x.com/sapnakmd)
Please visit: http://www.openpediatrics.org
OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu
Kudchadkar SR, O’Hara JE, Madden K. PICU Up!: Collaboration for Success by S. Kudchadkar | OPENPediatrics. 05/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/picu-up-collaboration-for-success-by-s-kudchadkar-openpediatrics
