Early Multimodal Therapy and Mechanical Ventilation

Exclusion Criteria

• •Invasive mechanical ventilation through tracheostomy or a nasotracheal tube.
• •History of head and neck surgery at any time prior to ICU admission.
• •Patients directly admitted to the ICU due to cardiac arrest by any cause.
• •Airway burn.
• •Burns involving ≥ 50% of the body surface area.
• •Chronic obstructive pulmonary disease (these patients usually require prolonged mechanical ventilation due to the underlying respiratory dysfunction)
• •Patients referred from another institution.
• •Demyelinating diseases or neuromuscular junction disorders at ICU admission.
• •Patients requiring neuromuscular blockade.
• •Patients with a life expectancy of ≤180 days will be excluded based on their primary diagnosis (e.g., advanced cancer, end-stage heart failure), comorbidities, recent clinical course, medical judgment by the ICU team, and functional status as assessed by the Barthel index.
• •ICU readmissions.
• •Participation in other rehabilitation clinical trials.
• •Liver or kidney transplant.
• •Patients with an active cancer diagnosis undergoing oncological treatment (chemotherapy/surgery) at the time of eligibil- ity assessment.