Course Description:

Mechanical ventilation is a method to replace or assist spontaneous breathing when patients are unable to breathe sufficiently on their own. It can be used to decrease the work of breathing and respiratory muscle fatigue, reverse life-threatening hypoxemia or acute progressive respiratory acidosis, increase lung volume, and decrease or prevent atelectasis. Mechanical ventilation is most often used for a few days during a critical illness. This type of breathing support is usually administered in the intensive care unit (ICU). Some patients who have difficulty discontinuing mechanical ventilation after an acute illness has resolved or who have stable chronic conditions requiring extended breathing support might receive prolonged mechanical ventilation in pulmonary rehabilitation units, in long-term care facilities, or at home. Physical therapy intervention is indicated to address adverse outcomes of prolonged immobilization while on mechanical ventilation, such as skeletal muscle weakness, deconditioning, and reduced functional ability, as well as to improve or prevent respiratory complications such as ventilator-associated pneumonia and inadequate secretion clearance. There is support for early mobilization of ventilated patients to improve functional outcomes and facilitate earlier weaning from ventilation, although evidence about specific techniques and protocols to use is limited.