D25-25 Breathing New Life Into ICU Rehabilitation: Respiratory Therapist Integration Boosts Mobility and Outcomes

Rationale

Acute respiratory failure requiring mechanical ventilation (MV) carries high morbidity, with ICU-acquired weakness (ICUAW) contributing substantially to long-term functional impairment. Early ICU rehabilitation improves recovery, but respiratory instability often limits mobility. Integrating respiratory therapists (RTs) into rehab sessions may optimize oxygenation and support higher activity levels.

Objective

To assess whether adding an RT to structured ICU rehabilitation improves patient mobility, safety, and clinical outcomes.

Design, Setting, Participants

University Academic Medical Center Medical Intensive Care Unit. A 5-week Medical ICU pilot was compared with an 8-week baseline period. The pilot included 67 Mechanically Ventilated patients; baseline included 75.

Methods

Standard coordination among rehab and nursing teams continued. For pilot patients, RTs were added to the care team via the electronic medical record and attended scheduled therapy sessions to manage respiratory needs. No other workflow changes occurred.

Results

During the pilot, more MV patients were treated daily (2.68 vs. 1.87). Mobility improved, with a 6% increase in patients mobilized to at least the edge of bed and >10% more patients reaching their maximum therapeutic level. Total upright time increased with RT support. Notably, no sessions ended due to tachypnea, agitation, or desaturation <88%, compared with 8% of baseline sessions. Average inpatient length of stay decreased from 13.3 days at baseline to 10.8 days in the pilot.

Conclusions

Embedding RTs into ICU rehabilitation enhances mobility intensity, reduces session interruptions from respiratory instability, and is associated with shorter inpatient length of stay. This targeted, scalable intervention offers a promising approach for strengthening ICU rehabilitation programs and addressing ICUAW.

This abstract is funded by: None