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Purpose Early mobilization within 72 h of intensive care unit (ICU) admission improves functional status at hospital discharge. We aimed to assess the effectiveness of early, goal-directed mobilization in critically ill patients across a broad spectrum of initial consciousness levels. Methods Post hoc analysis of the international, randomized, controlled, outcome-assessor blinded SOMS trial conducted 2011-2015. Randomization was stratified according to the immediate post-injury Glasgow Coma Scale (GCS) ([less than or equal to] 8 or > 8). Patients received either SOMS-guided mobility treatment with a facilitator or standard care. We used general linear models to test the hypothesis that immediate post-randomization GCS modulates the intervention effects on functional independence at hospital discharge. Results Two hundred patients were included in the intention-to-treat analysis. The significant effect of early, goal-directed mobilization was consistent across levels of GCS without evidence of effect modification, for the primary outcome functional independence at hospital discharge (p = 0.53 for interaction), as well as average achieved mobility level during ICU stay (mean achieved SOMS level) and functional status at hospital discharge measured with the functional independence measure. In patients with low GCS, delay to first mobilization therapy was longer (0.7 ± 0.2 days vs. 0.2 ± 0.1 days, p = 0.008), but early, goal-directed mobilization compared with standard care significantly increased functional independence at hospital discharge in this subgroup of patients with immediate post-randomization GCS [less than or equal to] 8 (OR 3.67; 95% CI 1.02-13.14; p = 0.046). Conclusion This post hoc analysis of a randomized controlled trial suggests that early, goal-directed mobilization in patients with an impaired initial conscious state (GCS [less than or equal to] 8) is not harmful but effective., Author(s): Stefan J. Schaller [sup.1], Flora T. Scheffenbichler [sup.2], Somnath Bose [sup.3], Nicole Mazwi [sup.4], Hao Deng [sup.2], Franziska Krebs [sup.1], Christian L. Seifert [sup.5], George Kasotakis [sup.6], Stephanie D. [...]

Author(s): Maximilian Hammer [sup.1], Stephanie D. Grabitz [sup.1], Bijan Teja [sup.1] [sup.2], Marjorie Serrano [sup.3], Matthias Eikermann [sup.1] [sup.4], Flora T. Scheffenbichler, Shannon Stillwell, Karuna Wongtangman, Karen Waak, Xinling Xu, [...]