Sedation Management and Physical Therapy

The major long-term morbidity of ARDS is neurologic and/or musculoskeletal disability related to prolonged inactivity.29,30 Consequently, at the earliest possible time, patients should undergo a daily awakening trial (“sedation holiday”)47 and should be started on an aggressive program of early mobilization. This consists of a staged approach even while intubated, beginning with passive range of motion (performed multiple times daily by providers, nurses, therapists, co-workers, and family) and then progressing to sitting up at the side of the bed, moving from bed to chair, and ambulating with assistance.48, 49