{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T10:38:47Z","timestamp":1792492727460,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Early mobilization of mechanically ventilated patients within 72\u2009hours of intubation is underutilized despite its known clinical benefits. The most cited barrier to implementation is physiologic instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify eligibility for early mobilization across established physiologic criteria in a multicenter cohort of mechanically ventilated adults and estimate the relative impact of structural and process implementation barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort of adults receiving invasive mechanical ventilation for \u22654\u2009hours across nine CLIF Consortium health systems (2018\u20132024) and MIMIC-IV (2008\u20132022). Four physiologic eligibility criteria, from clinical trials (Chicago, TEAM) and consensus guidelines (Green, Yellow), were applied between 8am and 5pm within 72\u2009hours of intubation. Random-effects meta-analysis compared eligibility across criteria and quantified the relative effect of two implementation barriers: weekday-only availability (structural) and 4-hour continuous eligibility (process).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Among 223,281 hospitalizations, 86.9\u201395.6% met eligibility for mobilization within 72\u2009hours of intubation across all 4 criteria. Compared with Chicago trials criteria, eligibility was reduced under TEAM (SHR 0.782, 95% CI 0.746\u20130.820) and Green (SHR 0.631, 0.611\u20130.651) but not Yellow (SHR 0.990, 0.976\u20131.005). Restricting eligibility to weekdays (structural) or requiring continuous eligibility (process) each reduced eligibility by 26-39% across all four criteria (SHR range 0.61\u20130.74); imposing both barriers together reduced eligibility by 45-56% (SHR range 0.44-0.55).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most mechanically ventilated adults met physiologic eligibility criteria for early mobilization within 72\u2009hours of intubation. Structural and process barriers, such as staff availability on weekends and sustained eligibility for care coordination, reduced opportunity more potently than physiologic instability alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag326","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:43:00Z","timestamp":1792489380000},"source":"Crossref","is-referenced-by-count":0,"title":["Eligibility for Early Mobilization in Mechanically Ventilated Adults: A Multicenter Study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6517-2175","authenticated-orcid":false,"given":"Bhakti K","family":"Patel","sequence":"first","affiliation":[{"name":"University of Chicago Department of Medicine, Section of Pulmonary and Critical Care, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0856-6885","authenticated-orcid":false,"given":"Kaveri","family":"Chhikara","sequence":"additional","affiliation":[{"name":"University of Chicago Department of Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1712-976X","authenticated-orcid":false,"given":"Snigdha","family":"Jain","sequence":"additional","affiliation":[{"name":"Yale University Section of Pulmonary, Critical Care, and Sleep Medicine, , New Haven, CT,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5565-3496","authenticated-orcid":false,"given":"Krysta","family":"Wolfe","sequence":"additional","affiliation":[{"name":"University of Chicago Department of Medicine, Section of Pulmonary and Critical Care, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4376-5754","authenticated-orcid":false,"given":"Chad H","family":"Hochberg","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Division of Pulmonary and Critical Care Medicine, Department of Medicine, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0719-6838","authenticated-orcid":false,"given":"Anna K","family":"Barker","sequence":"additional","affiliation":[{"name":"University of Michigan Division of Pulmonary and Critical Care, , Ann Arbor, MI,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0292-0594","authenticated-orcid":false,"given":"Nicholas E","family":"Ingraham","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School; University of Minnesota Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, , Minneapolis, MN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1557-2787","authenticated-orcid":false,"given":"Patrick G","family":"Lyons","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University Department of Medicine, , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7192-9907","authenticated-orcid":false,"given":"Brenna","family":"Park-Egan","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University Department of Medicine, , Portland, OR,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-3943","authenticated-orcid":false,"given":"Catherine A","family":"Gao","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine Division of Pulmonary and Critical Care, Department of Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5070-5610","authenticated-orcid":false,"given":"Wan Ting","family":"Liao","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine Division of Pulmonary and Critical Care, Department of Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-4575","authenticated-orcid":false,"given":"Juan C","family":"Rojas","sequence":"additional","affiliation":[{"name":"Rush University Division of Pulmonology, Critical Care, and Sleep Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5718-3328","authenticated-orcid":false,"given":"Kevin G","family":"Buell","sequence":"additional","affiliation":[{"name":"Rush University Division of Pulmonology, Critical Care, and Sleep Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7507-6634","authenticated-orcid":false,"given":"Vaishvik","family":"Chaudhari","sequence":"additional","affiliation":[{"name":"Rush University Division of Pulmonology, Critical Care, and Sleep Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8409-3111","authenticated-orcid":false,"given":"Alexander C","family":"Ortiz","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7508-7345","authenticated-orcid":false,"given":"Aartik","family":"Sarma","sequence":"additional","affiliation":[{"name":"University of California Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, , San Francisco,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6461-985X","authenticated-orcid":false,"given":"Andrew","family":"Willmore","sequence":"additional","affiliation":[{"name":"University of California Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, , San Francisco,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9640-6720","authenticated-orcid":false,"given":"Siva","family":"Bhavani","sequence":"additional","affiliation":[{"name":"Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7881-1356","authenticated-orcid":false,"given":"Navya","family":"Tippananapalya Ramesh","sequence":"additional","affiliation":[{"name":"Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6000-3153","authenticated-orcid":false,"given":"William F","family":"Parker","sequence":"additional","affiliation":[{"name":"University of Chicago Medicine MacLean Center for Clinical Medical Ethics, , Chicago, IL,","place":["USA"]},{"name":"University of Chicago Department of Public Health Sciences, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,20]]},"container-title":["Annals of the American Thoracic 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