A Scoping Review of Early Rehabilitation Strategies for Critically Ill Children

JING WANG ^* Zhuo Zou ^* Haoyu Huang yangping Zhang ^* Xianzhao Wei ^* Shuyue Yin ^* Yingjuan Chen ^* Yun Liu ^*

• Kunming Children's Hospital, Kunming, China

Background: Critically ill children often face prolonged recovery due to the severity of their illness and the impact of intensive care interventions. Early rehabilitation strategies have emerged as a crucial component in mitigating long-term morbidity and improving outcomes. However, the landscape of these strategies is diverse, and a comprehensive understanding of their efficacy and implementation is essential for guiding clinical practice and future research.Objective: This scoping review aims to map the existing literature on early rehabilitation strategies for critically ill children, identify the range of interventions used, and assess their reported efficacy and gaps in knowledge.Methods: A systematic search was conducted across multiple databases, including PubMed, Embase, and Cochrane Library, from January 2010 to December 2024. Keywords used included "early rehabilitation," "critical illness," "pediatric," "intensive care," and "recovery." The search identified 150 studies, of which 66 were included based on predefined criteria focusing on early rehabilitation interventions in pediatric critical care settings.The included studies encompassed a variety of rehabilitation strategies, such as wake-up techniques, cardiopulmonary rehabilitation techniques, swallowing rehabilitation techniques and exercise rehabilitation techniques. Quantitative findings revealed significant improvements in physical function and reduced length of stay in some studies, while qualitative insights highlighted the importance of multidisciplinary collaboration and family involvement in enhancing patient engagement and outcomes. However, the evidence was heterogeneous, with limited randomized controlled trials, and substantial variability in intervention protocols and outcome measures.Early rehabilitation strategies show promise in improving outcomes for critically ill children, emphasizing the need for standardized protocols and further research to enhance efficacy and implementation. This review highlights the current strategies, their potential benefits, and identifies key areas for future investigation, including the development of tailored interventions and long-term follow-up studies.