Physical and occupational therapy utilization in a pediatric intensive care unit - 2017

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Accepted Manuscript Physical and occupational therapy utilization in a pediatric intensive care unit

Liang R. Cui, Megan LaPorte, Matthew Civitello, Meg Stanger, Maxine Orringer, Frank Casey, Bradley A. Kuch, Sue R. Beers, Cynthia A. Valenta, Patrick M. Kochanek, Amy J. Houtrow, Ericka L. Fink PII: DOI: Reference:

S0883-9441(17)30023-0 doi: 10.1016/j.jcrc.2017.03.003 YJCRC 52440

To appear in: Please cite this article as: Liang R. Cui, Megan LaPorte, Matthew Civitello, Meg Stanger, Maxine Orringer, Frank Casey, Bradley A. Kuch, Sue R. Beers, Cynthia A. Valenta, Patrick M. Kochanek, Amy J. Houtrow, Ericka L. Fink , Physical and occupational therapy utilization in a pediatric intensive care unit. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Yjcrc(2017), doi: 10.1016/j.jcrc.2017.03.003

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ACCEPTED MANUSCRIPT Physical and Occupational Therapy Utilization in a Pediatric Intensive Care Unit

Liang R. Cui, MD1*; Megan LaPorte2*; Matthew Civitello, MPT3; Meg Stanger, MSPT4;; Maxine Orringer, MA, CCC-SLP 5; Frank Casey III, MD6; Bradley A. Kuch, MHA, RRT-NPS, FAARC7; Sue R.

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Beers, PhD8; Cynthia A. Valenta, MSN, RN, CNRN7; Patrick M. Kochanek, MD7; Amy J. Houtrow

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MD, PhD, MPH9; Ericka L. Fink MD, MS7 * Co-first authors Christiana Care, Wilmington, Delaware, USA

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University of Pittsburgh School of Health and Rehabilitation Science, Pittsburgh, PA, USA

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NeMours Children’s Hospital, Orlando FL, USA

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Physical Therapy Department, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh,

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Pennsylvania, USA 5

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Department of Audiology and Speech Pathology, Children’s Hospital of Pittsburgh of UPMC,

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Pittsburgh, Pennsylvania, USA

Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, USA

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Department of Critical Care Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh,

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Pennsylvania, USA

Department of Psychiatry, Western Psychiatric Institute and Clinic of UPMC, Pittsburgh, PA,

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Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA,

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ACCEPTED MANUSCRIPT Corresponding Author Ericka L. Fink, MD, MS Associate Professor Division of Pediatric Critical Care Medicine

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Children's Hospital of Pittsburgh of UPMC

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4401 Penn Avenue Faculty Pavilion, 2nd floor

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Pittsburgh, PA 15224 (office) 412-692-5164

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(fax) 412-692-6076

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[email protected]

Findings from this research have not been previously published as a research manuscript.

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All authors are responsible for reported research and have no conflicts of interest.

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The funding sources for this study had no involvement in the study design, collection, analysis and interpretation of data, writing the report, or in the decision to submit the article for publication.

ACCEPTED MANUSCRIPT Abstract Purpose: To characterize the use of physical therapy (PT) and occupational therapy (OT) consultation in our pediatric intensive care unit (PICU). Materials and Methods: We studied children aged 1 week – 18 years admitted to a tertiary

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care PICU for ≥ 3 days. Patient characteristics, details of PT and OT sessions and adverse events

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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

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regression for factors associated with outcome.

Results: Of 138 children studied, 40 (29%) received PT and OT consultation. Services were

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initiated 6.9 ± 10.0 (mean ± standard deviation) days after PICU admission. Range of motion

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(83%) was the most common therapy provided and 28% of patients were ambulated. Sixty-four

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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

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scores (all p