To study all ICU patients with an independent baseline functional status , who experience a critical illness requiring intubation and mechanical ventilation evaluating long-term cognitive and executive function and long term cost effectiveness in survivors who required mechanical ventilation.

Immediate mobilization of mechanically ventilated (MV) ICU patients is not part of usual care in the U.S. or internationally. Our previous work supports that early mobilization through physical and occupational therapy for ICU patients on the ventilator can help them experience less delirium, spend less time in the ICU and hospital, and become more independent when they leave. To advance our knowledge in this area, large longitudinal studies are needed to understand the long-term physical, cognitive and mental health status of survivors and to test how specific ICU therapies may affect these outcomes.

Inclusion Criteria:

• Intubated and MV > 24, < 96 hours
• Baseline Barthel Index Functional Score > 70, functional at home

Exclusion Criteria:

• Rapidly changing neurological conditions (e.g. stroke)
• Cardiac arrest as cause for respiratory failure
• Elevated intracranial pressure
• Pregnancy (due to inability to provide continuous fetal monitoring)
• Terminal condition (life expectancy < 6 months)
• Traumatic brain injury, multiple limb fractures, pelvic fractures,
• Severe chronic pain syndrome on admission