Pediatrics international : official journal of the Japan Pediatric Society最新文献

{"title":"Antenatal mgnesium sulfate and ritodrine increased potassium levels in preterm infants: A cohort study.","authors":"Seigo Hira,&nbsp;Ryoichi Ban,&nbsp;Satoru Ogawa,&nbsp;Kyoko Sakai,&nbsp;Kimitaka Takitani,&nbsp;Akira Ashida","doi":"10.1111/ped.15315","DOIUrl":"https://doi.org/10.1111/ped.15315","url":null,"abstract":"<p><strong>Background: </strong>Ritodrine and magnesium sulfate are administered to prevent preterm labor. Magnesium sulfate is also administered to prevent preeclampsia. These drugs have been reported to increase potassium levels in pregnant women and neonates. The aim of this study was to investigate the relationship between potassium levels in preterm infants and antenatal treatment.</p><p><strong>Methods: </strong>This prospective cohort study was conducted at Saiseikai Suita Hospital. Preterm infants born at <35 weeks' gestation between October 2012 and September 2014 were recruited and divided into four groups based on the antenatal treatment their mothers received. Serum and urine electrolyte levels at birth and serum potassium levels 1 day after birth were measured.</p><p><strong>Results: </strong>The mothers of 16 infants received no antenatal treatment (condition C); the mothers of 29 infants received antenatal ritodrine (R); the mothers of seven infants received magnesium sulfate (M); and the mothers of 15 infants received both magnesium sulfate and ritodrine (M + R). At birth, potassium levels were similar among the four groups. However, potassium levels a day after birth were significantly higher in the M + R group than in the other groups: median (min.-max.) mEq/L 4.8 (3.8-6.2), 4.8 (3.6-6.0), and 4.4 (3.8-5.9) vs. 5.8 (4.9-7.2), in the C, R, and M groups versus the M + R group, respectively (P < 0.01). Significantly more infants in the M + R group exhibited a fractional excretion of potassium of <10% compared with those in the other groups.</p><p><strong>Conclusion: </strong>The increased potassium levels we observe in preterm infants of mothers who received antenatal magnesium sulfate and ritodrine administration on postnatal day 1 warrant monitoring by neonatologists.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e15315"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40444258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiologic evaluation of Turkish mitochondrial fatty acid oxidation disorders.","authors":"Mehmet Cihan Balci,&nbsp;Meryem Karaca,&nbsp;Yakup Ergul,&nbsp;Rukiye Eker Omeroglu,&nbsp;Mubeccel Demirkol,&nbsp;Gulden Fatma Gokcay","doi":"10.1111/ped.15317","DOIUrl":"https://doi.org/10.1111/ped.15317","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial fatty acid oxidation disorders (FAODs) cause impairment in energy metabolism and can lead to a spectrum of cardiac pathologies including cardiomyopathy and arrhythmias. The frequency of underlying cardiac pathologies and the response to recommended treatment in FAODs was investigated.</p><p><strong>Methods: </strong>Sixty-eight children (35 males, 33 females) with the diagnosis of a FAOD were included in the study. Cardiac function was evaluated with 12-lead standard electrocardiography, echocardiography, and 24 h Holter monitoring.</p><p><strong>Results: </strong>Forty-five patients (66%) were diagnosed after disease symptoms developed and 23 patients (34%) were diagnosed in the pre-symptomatic period. Among symptomatic patients (n: 45), cardiovascular findings were detected in 18 (40%) patients, including cardiomyopathy in 14 (31.1%) and conduction abnormalities in 4 (8.8%) patients. Cardiac symptoms were more frequently detected in primary systemic carnitine deficiency (57.1%). Patients with multiple acyl-CoA dehydrogenase, long-chain 3-hydroxyacyl-CoA dehydrogenase, and mitochondrial trifunctional protein deficiencies also had an increased frequency of cardiac symptoms. Patients with medium-chain acyl-CoA dehydrogenase, very long-chain acyl-CoA dehydrogenase, and carnitine palmitoyltransferase I deficiencies had a lower prevalence of cardiac symptoms both during admission and during clinical follow up. Cardiomyopathy resolved completely in 8/14 (57%) patients and partially in 2/14 (14.3%) patients with treatment. Two patients with cardiomyopathy died in the newborn period; cardiomyopathy persisted in 1 (7.1%) patient with very long-chain acyl-CoA dehydrogenase deficiency.</p><p><strong>Conclusion: </strong>Early diagnosis, treatment and follow up made a significant contribution to the improvement of cardiac symptoms of patients with FAODs.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e15317"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qing-Dai for pediatric ulcerative colitis multicenter survey and systematic review.","authors":"Takahiro Kudo,&nbsp;Keisuke Jimbo,&nbsp;Hirotaka Shimizu,&nbsp;Itaru Iwama,&nbsp;Takashi Ishige,&nbsp;Tatsuki Mizuochi,&nbsp;Katsuhiro Arai,&nbsp;Hideki Kumagai,&nbsp;Keiichi Uchida,&nbsp;Daiki Abukawa,&nbsp;Toshiaki Shimizu","doi":"10.1111/ped.15113","DOIUrl":"https://doi.org/10.1111/ped.15113","url":null,"abstract":"<p><strong>Background: </strong>Pediatric ulcerative colitis (UC) is more challenging to treat than adult UC. Qing-Dai therapy is effective in adults but reports of its efficacy in children are unavailable. We conducted a questionnaire survey on Qing-Dai use among pediatric patients with UC in Japan to determine its efficacy and safety.</p><p><strong>Methods: </strong>Questionnaires were sent to 31 high-volume centers treating pediatric patients with inflammatory bowel disease. The number of patients using Qing-Dai, short-term and long-term effects, and adverse events were assessed. A systematic review of studies on the efficacy and safety of Qing-Dai usage for UC was also performed.</p><p><strong>Results: </strong>Overall, 29/31 facilities (93.5%) responded, Qing-Dai was used in 107 patients with UC, and 84/107 patients (78.5%) initiated treatment. Within 6 months, 81/101 (80.2%) patients had clinical remission, while 59/92 (64.1%) patients had no relapse and 29/92 (31.5%) experienced only one to two relapses yearly. Eighty-seven percent of the patients underwent regular follow ups for adverse events, among whom one patient was diagnosed with pulmonary arterial hypertension (PAH), five with enteritis, and one with headache. In the systematic review, the clinical remission rate was 50-80%, and PAH was observed in 14 of 1,158 patients (1.2%).</p><p><strong>Conclusions: </strong>Qing-Dai is highly effective in treating pediatric UC. However, Qing-Dai should be administered with caution as it may cause adverse events such as PAH.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e15113"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Index for the appropriate vancomycin dosing in premature neonates and infants.","authors":"Aiju Endo,&nbsp;Atsushi Nemoto,&nbsp;Kazumi Hanawa,&nbsp;Takahiro Ishikawa,&nbsp;Mai Koshiishi,&nbsp;Yuki Maebayashi,&nbsp;Yohei Hasebe,&nbsp;Atsushi Naito,&nbsp;Yoshifumi Kobayashi,&nbsp;Katsuhiko Isobe,&nbsp;Yayoi Kawano,&nbsp;Takehisa Hanawa","doi":"10.1111/ped.14905","DOIUrl":"https://doi.org/10.1111/ped.14905","url":null,"abstract":"<p><strong>Background: </strong>In neonates, vancomycin (VCM) is used to treat Gram-positive bacterial infections. However, VCM blood concentrations are affected by gestational age, bodyweight (BW), and renal function. The initial VCM dose adjustment can therefore be difficult, and few reports have evaluated this issue. In this study, we investigated the factors determining the appropriate VCM dosing schedule in neonates, especially premature infants.</p><p><strong>Methods: </strong>The VCM dosage and trough concentrations were retrospectively investigated from the initial treatment to maintenance therapy in neonatal intensive care unit patients who underwent therapeutic drug monitoring. We examined the average single-administration VCM dosage during maintenance therapy. We then compared the actual VCM dose with that calculated using an index comprising six items that influence the VCM daily dose (postnatal age, gestational age, BW, serum creatinine level, urine output, and lactate level).</p><p><strong>Results: </strong>Twenty premature infants were included. The average BW of patients at the initial VCM administration was 975 g. During maintenance therapy, the average VCM dose was 8.4 mg/kg, and the median trough concentration was 12.4 μg/mL. When we applied the six-item index, 18 of 20 patients (90%) had concordant results between the actual VCM dosing schedule and the VCM calculated using the index.</p><p><strong>Conclusions: </strong>The average VCM dose and six-item index can facilitate the transition from the initial VCM dose to an appropriate dose in many cases and contribute to early treatment in low-birthweight infants with more variable BW, distribution volumes, and renal function. In conclusion, our six-item index may help standardize VCM administration in premature infants.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e14905"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ped.14905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39127862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing norms on the Japanese version of the Eyberg Child Behavior Inventory.","authors":"Fumie Ito,&nbsp;Miyuki Matano,&nbsp;Ikuko Kato,&nbsp;Yukifumi Monden,&nbsp;Yuki Sunohara,&nbsp;Masako Kawasaki,&nbsp;Hitoe Kimura,&nbsp;Shima Furuichi,&nbsp;Regina Bussing,&nbsp;Yuka Oe,&nbsp;Nobuaki Morita,&nbsp;Yoshiharu Kim,&nbsp;Elizabeth Brestan-Knight,&nbsp;Sheila Eyberg,&nbsp;Toshiko Kamo","doi":"10.1111/ped.14910","DOIUrl":"https://doi.org/10.1111/ped.14910","url":null,"abstract":"<p><strong>Background: </strong>The Eyberg Child Behavior Inventory (ECBI) is one of the standardized parent rating scales used to identify disruptive behavior problems in children in Western countries. This study aimed to determine norms for the Japanese version of the ECBI, including clinical cutoff scores among the general population in Japan.</p><p><strong>Methods: </strong>This study established norms for the Japanese version of the ECBI using a sample of 1,992 parents of children aged 2-7, living in Japan. The research evaluates the validity and the reliability of the ECBI scores for the Intensity Scale and the Problem Scale. After validation, a clinical cutoff value of the ECBI scores was calculated, setting the cutoff to above the +1 standard deviation (SD) level based on the population distribution.</p><p><strong>Results: </strong>The means of the Intensity and Problem Scale scores were 100.07 and 6.57, respectively. Cronbach's α for both the Intensity and the Problem scores was 0.91. At this point, we propose cutoff scores of 125 for the Intensity Scale and 14 for the Problem Scale.</p><p><strong>Conclusions: </strong>Our results suggest that the Japanese version of the ECBI is highly reliable and may be useful as a tool for assessing behavior problems in children.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e14910"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ped.14910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39161039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute lymphoblastic leukemia in infants: A quarter century of nationwide efforts in Japan.","authors":"Daisuke Tomizawa,&nbsp;Takako Miyamura,&nbsp;Katsuyoshi Koh,&nbsp;Eiichi Ishii","doi":"10.1111/ped.14935","DOIUrl":"https://doi.org/10.1111/ped.14935","url":null,"abstract":"<p><p>Acute lymphoblastic leukemia (ALL) with KMT2A gene rearrangement (KMT2A-r) in infants is a biologically and clinically unique disease and one of the most difficult to cure forms of pediatric leukemia. Multicenter clinical trials have been carried out in Japan since the mid-1990s by introducing allogeneic hematopoietic stem cell transplantation (HSCT) in first remission, which led to a modest improvement in outcome of infants with KMT2A-r ALL. Because of the emerging evidence that HSCT does not benefit every infant with KMT2A-r ALL, the Japanese Pediatric Leukemia/Lymphoma Study Group trial MLL-10 introduced risk stratification using age and presence of central nervous system leukemia, and introduced intensive chemotherapy, including high-dose cytarabine in early consolidation; indication of HSCT was restricted to the patients with high-risk features. The trial resulted in excellent 3-year event-free survival of 66.2% (standard error, 5.6%) and overall survival of 83.9% (standard error, 4.3%) for 75 patients with KMT2A-r ALL recruited between 2011 and 2015. This Japanese experience and the results of the infant ALL trials worldwide suggest the importance of introducing effective therapy in the early phase of therapy, thus clearing minimal residual disease as rapidly as possible. However, further improvement in outcome is unlikely with conventional treatment approaches. Introduction of biology-driven novel agents and/or immunotherapies through international collaboration would be key solutions to overcome the disease.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e14935"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39257869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case series of arginase 1 deficiency: Expanding the spectrum in hyperargininemia.","authors":"Sevil Dorum,&nbsp;Cengiz Havalı","doi":"10.1111/ped.14945","DOIUrl":"https://doi.org/10.1111/ped.14945","url":null,"abstract":"<p><strong>Background: </strong>Arginase-1 deficiency is a rare, autosomal recessively inherited disorder of the urea cycle. In this study, we describe the clinical and molecular details of six patients who were diagnosed with argininemia, and we describe two of the patients with hyperargininemia who carried two novel variations of the Arginase-1 gene.</p><p><strong>Methods: </strong>The clinical and demographic characteristics of the patients were retrospectively evaluated.</p><p><strong>Results: </strong>The ages of the six patients ranged from 1 day to 20 years, and each patient had consanguineous parents. Neuromotor retardation and spastic paraparesis were found in all patients except one, who was diagnosed prenatally. Hyperargininemia was present in all patients. Urinary orotic acid excretion was increased in four of the six patients. The diagnosis was confirmed by genetic analysis in all the patients. Elevated liver enzymes were detected in three patients and blood urea nitrogen levels were normal in each of the six patients.</p><p><strong>Conclusions: </strong>In this study, we describe the two patients with hyperargininemia who carried two novel variations of the ARG1 gene. Also, we present a patient with normal neurodevelopment who was diagnosed prenatally and treated at an early stage of the disease.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e14945"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ped.14945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39271801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive candidiasis in a neonatal intensive care unit in Fukuoka.","authors":"Eiji Ohta,&nbsp;Takashi Setoue,&nbsp;Kazutoshi Ito,&nbsp;Tatsurou Kodera,&nbsp;Yasuhiro Onda,&nbsp;Hiroyasu Kawano,&nbsp;Toshikazu Niimi,&nbsp;Hiroya Kakura,&nbsp;Mariko Morii,&nbsp;Tatsuki Miyamoto,&nbsp;Chizuru Hashiguchi,&nbsp;Masatoshi Nakamura,&nbsp;Shinichi Hirose","doi":"10.1111/ped.14949","DOIUrl":"https://doi.org/10.1111/ped.14949","url":null,"abstract":"<p><strong>Background: </strong>Invasive candidiasis (IC) is a leading cause of morbidity and mortality in preterm infants. The objective of this study was to determine the prevalence of IC infection in newborns in the neonatal intensive care unit (NICU) of a tertiary hospital in Japan, and to identify specific predisposing factors for IC.</p><p><strong>Methods: </strong>We retrospectively collected data on demographics, clinical characteristics, and outcomes of infants with IC, who were discharged from a tertiary NICU in Japan between January 2009 and December 2020. We compared predisposing factors associated with the occurrence of early-onset IC (EOIC < 72 h) and late-onset IC (LOIC ≥ 72 h) with those of early-onset and late-onset bacterial sepsis.</p><p><strong>Results: </strong>Between January 2009 and December 2020, 3,549 infants were admitted to the NICU, including 344 extremely-low birthweight (ELBW) infants. Eleven infants (including nine ELBW infants) had IC (incidence 0.31%), and the mortality rate of IC was 0%. Four (36%) infants had EOIC and seven (64%) had LOIC. All those with EOIC presented with skin lesions and 86% with LOIC had thrombocytopenia. Maternal vaginal Candida colonization was a more specific predisposing factor for EOIC, while gestational age <26 weeks, broad-spectrum antibiotic use, prior bacterial infection, prior gastrointestinal (GI) surgery, and GI diseases were more specific predisposing factors for LOIC.</p><p><strong>Conclusions: </strong>The findings suggest that maternal vaginal Candida colonization and skin lesions in ELBW infants may contribute to early recognition of EOIC. LOIC should be suspected if ELBW infants with several predisposing factors of LOIC have thrombocytopenia.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e14949"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ped.14949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39309769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating fibrocyte level in children with cystic fibrosis.","authors":"Pınar Aslan Yaşar,&nbsp;Mehmet Köse,&nbsp;Serife Erdem,&nbsp;Melih Hangül,&nbsp;Zehra Filiz Karaman,&nbsp;Ahmet Eken","doi":"10.1111/ped.15058","DOIUrl":"https://doi.org/10.1111/ped.15058","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate circulating fibrocyte levels in cystic fibrosis (CF) patients during stable and exacerbation periods of the condition.</p><p><strong>Methods: </strong>The study group consisted of 39 patients diagnosed with CF and 20 healthy controls. Individuals included in the study were divided into three groups: CF, CF exacerbated, and a healthy control group. Their circulating fibrocyte levels were compared. Findings from a pulmonary function test and high-resolution computed tomography of the lung were evaluated and compared.</p><p><strong>Results: </strong>The circulating fibrocyte count was found to be significantly higher in patients with CF compared with the exacerbated and control groups. No correlation was found between the forced expiratory volume in 1 s and forced vital capacity values in the pulmonary function test and the circulating fibrocyte count. The circulating fibrocyte count in patients (in the CF group) with positive findings in the high-resolution computed tomography was statistically significantly lower.</p><p><strong>Conclusions: </strong>The circulating fibrocyte level in the peripheral blood of the patients with CF was increased.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e15058"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39733112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-driven early rehabilitation protocol for critically ill children.","authors":"Chanapai Chaiyakulsil,&nbsp;Panitnard Thippanate","doi":"10.1111/ped.15048","DOIUrl":"https://doi.org/10.1111/ped.15048","url":null,"abstract":"<p><strong>Background: </strong>Physical impairment is a major morbidity in children surviving intensive care. The main objective of this study was to evaluate the effectiveness of a nurse-driven protocol in the early mobilization of critically ill children in terms of reduction of motor dysfunction, pediatric intensive care unit stays, and ventilator days. The secondary objective was to evaluate safety, in terms of injury, dislodgement of medical devices, and cardiorespiratory instability attributable to the intervention.</p><p><strong>Methods: </strong>The early rehabilitation intervention was initiated in July 2020. This retrospective interrupted time-series study was divided into the pre-implementation phase (January-June 2020) and the post-implementation phase (July-December 2020). The motor function domain of the Functional Status Scale was used to define the motor dysfunction after pediatric intensive care unit discharge.</p><p><strong>Results: </strong>Twenty-five children were allocated in each group. The median age of the whole cohort was 11.5 months and approximately 58% of the population was male. The baseline characteristics of both groups were not statistically significant. There was a statistically significant reduction in motor dysfunction after protocol implementation (64.0% vs 36.0%; P = 0.044) with an absolute risk reduction of 28%. The number needed to treat was 3.6 children. There were no statistically significant differences in the median ventilator days, length of stay in the intensive care unit, and hospital length of stay. No complications were found.</p><p><strong>Conclusions: </strong>A nurse-driven protocol for the early mobilization of critically ill children was feasible and could be effective in reducing post-intensive care motor dysfunction.</p>","PeriodicalId":206308,"journal":{"name":"Pediatrics international : official journal of the Japan Pediatric Society","volume":" ","pages":"e15048"},"PeriodicalIF":1.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39851017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}