title: Physical and occupational therapy utilization in a pediatric intensive care unit.
abstract: To characterize the use of physical therapy (PT) and occupational therapy (OT) consultation in our pediatric intensive care unit (PICU).
  
  
  
  We studied children aged 1week-18years admitted to a tertiary care PICU for ≥3days. Patient characteristics, details of PT and OT sessions and adverse events were collected. A multivariable logistic regression was performed to determine factors associated with receipt of PT and OT consultation with propensity analysis followed by a regression for factors associated with outcome.
  
  
  
  Of 138 children studied, 40 (29%) received PT and OT consultation. Services were initiated 6.9±10.0 (mean±standard deviation) days after PICU admission. Range of motion (83%) was the most common therapy provided and 28% of patients were ambulated. Sixty-four of 297 (21.5%) sessions were deferred and 7 (2.4%) sessions were terminated early due to physiologic instability with no serious adverse events. Children who received PT and OT were older, more likely to require neuromuscular blocking agents, and had lower pre-PICU POPC scores (all p<0.05).
  
  
  
  Data are needed to inform on the efficacy of rehabilitative therapies initiated in the ICU to improve outcome for critically ill children.
authors.affiliation: Christiana Care Health System, Wilmington, DE, USA.
authors.forename: Liang R
authors.initials: LR
authors.lastname: Cui
authors.affiliation: University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, PA, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: LaPorte
authors.affiliation: NeMours Children's Hospital, Orlando, FL, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Civitello
authors.affiliation: Physical Therapy Department, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Meg
authors.initials: M
authors.lastname: Stanger
authors.affiliation: Department of Audiology and Speech Pathology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Maxine
authors.initials: M
authors.lastname: Orringer
authors.affiliation: Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Casey
authors.affiliation: Department of Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Kuch
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA, USA.
authors.forename: Sue R
authors.initials: SR
authors.lastname: Beers
authors.affiliation: Department of Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Valenta
authors.affiliation: Department of Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kochanek
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Houtrow
authors.affiliation: Department of Critical Care Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA. Electronic address: finkel@ccm.upmc.edu.
authors.forename: Ericka L
authors.initials: EL
authors.lastname: Fink
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002673:Child, Hospitalized; D002675:Child, Preschool; D016638:Critical Illness / Q000451:nursing / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D016015:Logistic Models; D008297:Male; D009788:Occupational Therapy / Q000706:statistics & numerical data*; D010414:Pennsylvania; D010808:Physical Examination; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*
keywords: Critical illness; Occupational therapy; Pediatric; Physical therapy; Post-intensive care syndrome; Rehabilitation