الفهرس 
INTRODUCTION
The Ventilation Dependent Rehabilitation UnitOnly 14 pages are availabe for public view
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Abstract
Most of mechanically ventilated patient are weaned promptly as they recover, however; a small number of patients become clinically stable but remain ventilator dependent. Such patients are unable to return to the community and are obliged to remain in the ICU. Units accepting prolonged MV patients concentrate specialized expertise to optimize care, use hospital resources efficiently, and initiate long-term care planning. The ventilation-dependent rehabilitation unit (VDRU) is an ICU with a rehabilitative focus that is ideal for managing patients with prolonged MV. The care is provided by a team of highly trained health care professionals who develop and individualize treatment plans. A rehabilitation program is an essential part of the management plan. Weaning from MV should start as soon as possible after transfer to VDRU as 10-30% of patients with prolonged MV will tolerate their initial spontaneous breathing trial and be liberated. A sensible physiology-based approach to weaning that seems to be carried out throughout these VDRUs, focus on understanding and treating the overall medical status of the patient, recognizing the factors affecting weaning failure, optimizing the respiratory function, and minimizing the time spent on the ventilator. Reduced functional ability is one of several adverse outcomes of prolonged bed rest and MV during critical illness. Skeletal muscle weakness is known to be one of the major phenomena that account for reduced functional ability. Reviewing the published research on improving outcomes in patients undergoing prolonged MV support the ability of early physiotherapy techniques to improve outcomes in patients on prolonged MV. Chest physiotherapy techniques include breathing exercise, chest percussion, chest vibration, postural drainage and the use of oscillatory devices. The ICU patients have difficulty with communication and expressing needs and wishes. Therefore the ICU staff and next of kin will have to interpret the patient’s wishes and empower patients according to the later believes. Nutritional support in the critically ill patients, as a part of rehabilitation program, has 3 main objectives: to preserve lean body mass, to maintain immune function and to avert metabolic complications. Nutritional modulation of the stress response to critical illness includes early nutrition (either enteral or parental) to ensure appropriate macro and micro nutrients delivery Psychotherapy is an important part of the rehabilitation program. Elimination of unnecessary medications, careful attention to hydration and nutrition, pain control using adequate and appropriate measures, correction of sensory deficits, sleep enhancement, early mobilization and cognitive stimulation will help preventing delirium. While both pharmacological and non-pharmacological measures can be used to manage patients with delirium. In conclusion, a significant number of patients that have been critically ill require MV for long period as they progress towards recovery. Many of these patients can be cared for outside the ICU. In this essay, relevant literatures were reviewed and presented concering the inpatient rehabilitation programs for patients discharged from the respiratory ICU. Inpatient rehabilitation alleviates the burden of prolonged critical illness on MV patients and effectively shorten the time spent on MV and improve survival. It is worthwhile to implement studies, procedures, and practices that promote early care planning for patients undergoing prolonged MV.