Efficacy and safety of early mobilization protocols in critically ill patients pediatric: An integrative review

Abstract

Introduction: Technological advances in recent decades have reduced infant mortality due to critical factors, increasing the survival rate and, consequently, morbidity after admission to intensive care units. These conditions result in physical, neurocognitive, and psychosocial injuries with functional impact. Early mobilization has emerged as a safe strategy to minimize the effects of immobility, but there is still a shortage of pediatric protocols and institutional barriers to be overcome. Objective: To describe the efficacy and safety of early mobilization protocols in critically ill children admitted to the Pediatric Intensive Care Unit. Methodology: Integrative Literature Review, conducted using a structured protocol. The search was conducted in national and international databases, using previously established descriptors. Randomized clinical trials and cohorts addressing early mobilization in critically ill children were included, while studies in patients with hemodynamic instability and orthopedic surgery were excluded. After the screening process, six studies were selected to compose the final sample. Results: The main barriers encountered were the insecurity of legal guardians, the reluctance of the multidisciplinary team, the hemodynamic instability of the child, the willingness of professionals to perform Early Mobilization, and physiotherapy resources. Conclusion: Early mobilization in the Pediatric Intensive Care Unit is safe in critically ill children, but there are institutional barriers to be overcome. Further studies are needed to expand strategies and protocols.