Authors
Andrés Mauricio Enriquez Popayan, Henry Mauricio Parada-Gereda, Luis Alexander Peña-López, Longxiang Su, Milton Santillán-Zuta, Wilson Mauricio Lozano, Hongbo Luo, Daniel Lago Borges, Darío Salvador Villalba, Romina Amelia Pratto, José M Cruz-Touzet, Susana Arias-Rivera, Carmen Ana Cerron Cabezas, Rosana Goñi-Viguria, Marta Raurell-Torredá, Debora Stripari Schujmann, Patrick Sepúlveda Barisich, Santiago Nicolás Saavedra, Miguel Ángel Martínez Camacho, Leonardo Alexander Quevedo Florez, Ricardo Arriagada, Alexis Silva-Gutiérrez, Maritza Giovanna Soto Limo, Francisco Jimenez Salazar
Published in
Critical care science. Volume 38. Pages e20260058. Epub Aug 24, 2026.
Abstract
Although early mobilization is a cornerstone of modern critical care for reducing intensive care unit-acquired weakness, the duration of mechanical ventilation, and length of stay, its implementation remains highly variable due to the absence of standardized laboratory criteria to guide clinical decision-making. Therefore, this study aimed to generate safety recommendations regarding laboratory and blood count values to be considered prior to initiating early mobilization in critically ill adults, both with and without invasive supports, across different clinical conditions. To address this evidence gap, a modified Delphi process was conducted with 24 highly experienced intensive care unit staff, including physiotherapists, physicians, and nurses. All panelists met strict criteria related to clinical expertise, advanced training, and scientific productivity. Over eight iterative rounds, the panel achieved at least 85% agreement on 119 items across six clinical domains: respiratory, cardiovascular, renal, surgical, hematological/immunological, and neurological. Key laboratory parameters considered included hemoglobin, platelets, lactate, glucose, international normalized ratio, acid-base state (pH), and potassium in selected clinical contexts. The consensus also provides novel guidance in two previously underexplored areas: first, mobilization during blood product transfusions, recommending postponement of early mobilization until transfusion completion; and second, the importance of dynamic trends in routine laboratory tests, identifying clinically meaningful declines in hemoglobin: ≥ 2g/dL/24 hours and platelets: ≥ 20% within 24 hours as contraindications to mobilization. This consensus offers a pragmatic framework that has the potential to reduce interprofessional variability, enhance patient safety, and inform the development of local and national protocols, including in resource-limited settings. Nonetheless, prospective validation across different healthcare contexts is required to confirm its clinical impact and generalizability.
PMID:
42659441
Bibliographic data and abstract were imported from PubMed on 28 Aug 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 7
- Comments 0