Early In-bed Cycling in Critically Ill Children

This is a single centre, Pilot RCT that will evaluate in-bed cycling in addition to usual care physiotherapy, compared to usual care physiotherapy, on functional recovery in critically ill children. We will conduct a qualitative substudy to evaluate caregiver impressions of the intervention, and to understand barriers and facilitators to implementing early mobilization in critically ill children.

Inclusion criteria

• age ≥ 3 years to < 18 years;
• Limited to bed-rest or bed mobility at time of screening
• expected PICU stay for an additional 48 hours minimum, at time of screening
• informed consent and or assent where appropriate;
• agreement of the most responsible PICU physician.

Exclusion criteria

• Contraindications: e.g. Hemodynamic instability, unstable or uncontrolled arrhythmia, ICP, unstable airway, unstable fractures/spine
• Contraindication to mobilizing upper/lower limbs, e.g. femoral sheath
• Cycle ergometer does not fit body dimensions
• Already mobilizing well/expected to mobilize out of bed within 24h
• not expected to survive current admission - i.e. predicted hospital mortality of > 90%;