Authors
Matteo Di Nardo, Elisa Poletto, Ezio Bonanomi, Riccardo Carbonetti, Alessandra Conio, Elena Zardi, Silvana Massa, Giuseppe Pagano, Stefania Ferrario, Paolo Finazzi, Alberto Giannini, Angela Amigoni, Raffaella Sagredini, Giacomo Paluzzano, Nicola Reia, Roberta Pallotto, Veronica Recchiuti, Elisabetta Lampugnani, Geremia Zito Marinosci, Manuela L'Erario, Paola Moliterni, Riccardo Ricci, Marcello Piazza, Stefania Bianzina, Giulia Gorghelli, Sara Schirru, Manuela Moncada, Maria Cristina Mondardini, Italian Society of Neonatal, Pediatric Anesthesia, Intensive Care (SARNePI)
Published in
European journal of pediatrics. Volume 185. Issue 7. Jul 03, 2026. Epub Jul 03, 2026.
Abstract
Prolonged immobility contributes to pediatric intensive care unit (PICU)-acquired weakness and postintensive care syndrome (PICS). Early mobilization (EM) shows feasibility and potential benefits in adults, and pediatric experiences suggest safety, though data are limited and practice varies. There is a wide variability in Italy regarding EM practices. Thus, we aimed to develop consensus statements to standardize EM across Italian PICUs today while respecting local variability. This project was conducted by a 20-member multidisciplinary panel of Italian PICU experts, including nurses and physiotherapists. The project was endorsed by the Italian Society of Neonatal and Pediatric Anesthesia and Intensive Care (SARNePI). A comprehensive search (2010-2015 July 2025) in PubMed, CINAHL, and PEDro was conducted. Eligible studies included prospective and retrospective studies, systematic reviews, meta-analyses, and guidelines. Nine EM research areas were defined; Statements were drafted using a Quaker-based consensus methodology and voted using the RAND/UCLA appropriateness method. From 8380 records, 113 studies met eligibility. Twenty-two statements and four tables were drafted; 20 statements and three tables achieved strong agreement in the first round. The remaining two statements and one table were revised and were classified with weak agreement. Attendance was 93% at online meetings.
This EM consensus provides standardized, implementable statements to guide EM adoption across Italian PICUs while accommodating local practice differences; future work should focus on validation, implementation, and dissemination.
• Prolonged immobility in the PICU is one of the modifiable factors associated with PICU-acquired weakness, delirium, and post-intensive care syndrome. • In Italy only 15% of patients admitted to PICU receives Early Mobilization practices with great variability across PICUs.
• 22 pragmatic statements and four tables have been developed to promote standardized EM interventions across Italian PICUs, while accounting for variability of practices and equipment. • The provision of graded Early Mobilization, responsive to the child's condition and severity of illness, may promote functional recovery both during and beyond the PICU stay.
PMID:
42399446
Bibliographic data and abstract were imported from PubMed on 04 Jul 2026.
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