Intermediate respiratory care unit: rehabilitation.

The ventilator assisted individual (VAI) represents a complex set of medical and social issues that call for the involvement of multiple interest groups. The success of treatment for VAI depends on many factors. These include: appropriate selection of patients for care outside the hospital, clinical and physiological stability of patients, patient and family motivation, and their ability to learn. Assisted ventilation in chronic respiratory failure secondary to chest-wall deformities and neuromuscular disease has shown promising results. Less satisfactory have been those reported in patients with chronic obstructive pulmonary disease (COPD). COPD candidates for chronic mechanical ventilation should be carefully selected. Patients should not be discharged on ventilators to nonhospital environments before they are clinically stable. It is also crucial to rule out other medical diseases that could interfere with successful discharge and home-care. Discharge planning requires the support and involvement of the physicians, nurses, and other allied health professionals. Education is of vital importance and, as such, needs to begin early in the patient's hospital stay. A basic checklist of skills that the VAI and the family will need to know should be developed, as well as an individual rehabilitation programme planned according to the patient's primary problem, with realistic short- and long-term goals. The aim is to restore and maintain the best possible quality of life for the individual.