Abstract P-473

Aims & Objectives: Aims and objectives: Prolonged immobilization in critically ill patients is associated with severe short- and long-term sequelae. Recent studies explore the feasibility and effectiveness of early mobilization (EM) to attenuate these adverse effects in adults, however the literature in children is limited. We aim to review definitions and efficacy of early mobilization in critically ill patients in the pediatric intensive care unit (PICU). Methods We searched MEDLINE, Embase, CINAHL, CENTRAL, NIH, Evidence in Pediatric Intensive Care Collaborative, Physiotherapy Evidence Database, and the Mobilization-Network. We assessed randomized and non-randomized studies evaluating EM or early physical therapy, rehabilitation, exercise, and ambulation in critically ill patients <18 years of age. We extracted data defining mobility based rehabilitation strategies, what was considered EM, and feasibility of the interventions. We also assessed efficacy outcomes (death, days of PICU stay, and morbidities) and adverse events. Results Of 1,105 records identified, we included 8 studies (2 randomized trials). We did not pool data due to inconsistencies of populations and interventions. There were no increased adverse events attributable to EM, differences in death, morbidities, adverse events, and length of PICU days. The evidence was considered of very low certainty due to inconsistency, imprecision, and risk of bias. Most authors provide definitions of EM and characterize the interventions appropriately.Conclusions There is no consistent definition for what constitutes “early” mobilization or mobility-based therapy. Although these interventions are safe and feasible, there are still barriers for implementation. We found very-low certainty evidence on efficacy outcomes, including death, days of PICU stay, and morbidities.