Older patients now constitute a large proportion of ICU admissions, yet conventional severity scores may not adequately reflect their specific vulnerabilities. This study examined whether pre-ICU frailty, functional status, comorbidity burden and acute organ dysfunction at ICU admission were associated with 30-day all-cause mortality in patients aged ≥ 65 years, and whether the associations of geriatric vulnerability measures persisted in adjusted models that also included conventional physiology-based severity scores. In this multicentre prospective observational cohort study, 55 ICUs across 27 provinces in Türkiye enrolled consecutive eligible patients aged ≥ 65 years who had an ICU length of stay exceeding 48 h during a 1-month period. Pre-admission frailty and functional status were assessed using the Clinical Frailty Scale (CFS), FRAIL questionnaire and Katz Index of Activities of Daily Living (Katz ADL); comorbidity burden was assessed using the Charlson Comorbidity Index (CCI); and acute illness severity was assessed using the Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II (APACHE II) and modified Nutrition Risk in the Critically Ill (mNUTRIC) scores. The primary outcome was 30-day all-cause mortality after ICU admission. Kaplan–Meier and Cox regression analyses were framed as conditional 48-h landmark analyses. Follow-up began at the 48-h landmark; observed death times were retained, and all patients alive at day 30 were administratively censored at landmark day 28. A total of 1,529 patients were included (median age, 77 years), and 30-day all-cause mortality was 33.7%. Frailty was common, with 71.2% of patients having a CFS ≥ 5. In the conventional primary Cox model, CFS (aHR 1.190 per one-point increase, 95% CI 1.129–1.255) and SOFA (aHR 1.182 per one-point increase, 95% CI 1.152–1.212) were associated with mortality. In the centre-clustered robust model, CFS (aHR 1.190, 95% CI 1.104–1.283) and SOFA (aHR 1.182, 95% CI 1.143–1.222) remained statistically significant, whereas CCI was estimated with less precision and was not statistically significant (aHR 1.034, 95% CI 0.989–1.081). The extended conventional and centre-clustered robust models including APACHE II yielded the same substantive pattern. Comparisons of organ-support therapies and ICU-acquired complications across vulnerability strata were descriptive and unadjusted. In this selected cohort of ICU patients aged 65 years or older with an ICU length of stay exceeding 48 h, pre-admission frailty and early organ dysfunction showed the most robust associations with 30-day all-cause mortality, whereas chronological age was not independently associated in the adjusted models. These findings should not be interpreted as evidence that chronological age is irrelevant, but rather that frailty and acute organ dysfunction remained associated with mortality after adjustment for chronological age in this cohort.

Traditional predictors of weaning outcomes primarily focus on acute illness severity and physiological parameters, while geriatric vulnerability domains such as frailty, functional dependence, and nutritional risk are often overlooked. Evidence regarding the incremental prognostic value of these domains for predicting weaning failure in critically ill older patients remains limited. This study aimed to evaluate the association between pre-admission frailty, functional status, comorbidity burden, and acute organ dysfunction with weaning failure in critically ill patients aged ≥ 65 years, and to compare their prognostic contribution with traditional severity scores. This study is a secondary analysis of a national, multicenter, prospective observational cohort conducted across adult ICUs in Türkiye. Consecutive ICU patients aged ≥ 65 years who required invasive mechanical ventilation for more than 24 h were included. Multivariable logistic regression was used to identify factors independently associated with weaning failure. Weaning failure was defined as the need for reintubation within 7 days after extubation, death during the weaning process, or persistent requirement for invasive mechanical ventilation at day 90. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). A total of 647 critically ill older patients were included in the study. Weaning failure occurred in 347 patients (53.6

Introduction: Candidozyma (Candida) auris has emerged as a significant global public health threat in recent years due to its multidrug-resistant antifungal susceptibility profile and high epidemic potential. This study aimed to evaluate the risk factors, resistance profile, and outcomes of patients diagnosed with C. auris bloodstream infection. Material and Methods: This study was designed as a retrospective descriptive study. Patients followed up with C. auris bloodstream infection and C. auris colonization in the intensive care unit between May 2024 and May 2025 were included in the study. In cultures where growth was detected, microscopic examination, germ tube test, and matrix assisted laser desorption/ionization time of flight massspectrometry (Bruker Daltonics, Bremen, Germany) methods were used for yeast identification. Antifungal susceptibility testing for C. auris was performed by broth microdilution using the MICRONAUT-AM (Bruker Daltonics, Bremen, Germany) test. Results: A total of 24 patients, 17 with C. auris bloodstream infection and seven with C. auris colonization, were included in this study. The most common comorbidities in the patient group with C. auris bloodstream infection were cardiovascular diseases [hypertension 9/17 (52.9%), congestive heart failure 5/17 (29.4%), coronary artery disease 4/17 (23.5%)], chronic obstructive pulmonary disease 6/17 (35.3%), and diabetes mellitus 6/17 (35.3%), respectively. The most frequently identified risk factors were mechanical ventilation, central venous catheter, urinary catheter presence, and exposure to broad-spectrum antibiotics within the last 30 days. All C. auris isolates were resistant to fluconazole [minimum inhibitory concentration (MIC) median= 128 (interquartile range (IQR)= 128-128)] and caspofungin [MIC median= 4 (IQR 4-8)]. All C. auris isolates were susceptible to micafungin [MIC median= 0.125 (IQR= 0.06-0.125)], anidulafungin [MIC median= 0.125 (IQR 0.125-0.25)], and amphotericin B [MIC median= 1 (IQR= 1-1)]. The 28-day all-cause mortality rate was 58.82%. Conclusion: C. auris bloodstream infections have a high mortality rate. Additionally, the most striking finding of our study was the detection of caspofungin resistance in C. auris strains. In vitro caspofungin resistance should be confirmed with anidulafungin and micafungin susceptibility testing. Multicenter, prospective studies are needed.

The aim of this study was to investigate the relationship between mortality awareness and spiritual care competence among nurses working in intensive care and palliative care units. This cross-sectional, descriptive and correlational study included a sample of 163 nurses who had worked for at least one month in intensive care and palliative care units in two hospitals. Data were collected between 02/01/2024 and 28/06/2024. The mean total score of the nurses on the Multidimensional Mortality Awareness Scale was 122.59 ± 15.59 and the Spiritual Care Competence Scale was 105.85 ± 11.90. A positive significant relationship was found between mortality awareness and spiritual care competence ( p < .05). It was observed that as the mortality awareness of ICU and palliative care nurses increased, their spiritual care competence also increased.

Objectives Long-term outcomes of COVID-19 patients who discharge ICU are unclear. We investigated the effect of COVID-19 on lung structure, pulmonary functional, exercise capacity and quality of life in patients discharge from ICU and medical ward. Methods A prospective single-centre study conducted in PCR confirmed COVID-19 patients who has been discharged from University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Teaching and Research Hospital between 15 January and 5 March 2021. Patients who followed up for more than 48 hours in ICU and more than 72 hours in medical ward were included the study. Computed tomography scores, pulmonary functional tests (PFT), 6-min walking distance and health related quality of life by SF-36 were compared between ICU and medical ward patients at 6 months after discharge. Results Seventy patients were included final analyses and 31 of them discharged from ICU. ICU patients had higher CT scores than non-ICU patients at admission (17 vs 11) and follow up visit (6 vs 0). Two-three of ICU patients had at least one abnormal finding at control CT. Advanced age (OR 1.08, 95% CI 1.02-1.15) and higher CT score at admission (OR 1.13, 95% CI 1.01-1.27) were risk factors for having radiological abnormalities at control CT. 90% of the patients discharged from the ICU had at least one persistent symptom. Conclusion A number of COVID-19 survivors could not fully recover after 6 months of hospital discharge. COVID-19 survivor needs to support therapies at recovery phase of the disease.

OBJECTIVE:Coronavirus disease 2019 (COVID-19) caused morbidity and mortality worldwide. Besides the acute effects, subacute and long-term effects are defined as long-COVID causing morbidity. The intensive care unit (ICU) data of long-COVID-19 cases were evaluated with the participation of 11 centers. MATERIAL AND METHODS:Study was designed by Turkish Thoracic Society Respiratory Failure and Intensive Care Working Group to evaluate long COVID-19 patients. All patients followed up in the ICU with long-COVID diagnosis were included in point prevelance study. RESULTS:A total of 41 long COVID-19 patients from 11 centers were included in the study. Half of the patients were male, mean age was 66 ± 14, body mass index was 27 ± 5. Hypertension, diabetes mellitus, lung cancer, malignancy, and heart failure rates were 27%, 51%, 34%, 34%, and 27%, respectively. Eighty percent had received COVID vaccine. Patients had moderate hypoxemic respiratory failure. APACHE II, SOFA score was 18 (14-26), 6 (3-8), respectively. Forty-six percent received invasive mechanical ventilator support, 42% were sepsis, 17% were septic shock. Bilateral (67%), interstitial involvement (37%) were most common in chest x-ray. Fibrosis (27%) was detected in thorax tomography. Seventy-one percent of patients received antibiotherapy (42% carbapenem, 22% linezolid). Sixty-one percent of the patients received corticosteroid treatment. CONCLUSION:More than half of the patients had pneumonia and the majority of them used broad-spectrum antibiotics. Presence of comorbidities and malignancies, intensive care severity scores, intubation, and sepsis rates were high. Receiving corticosteroid treatment and extensive bilateral radiologic involvement due to COVID-19 might be the reasons for the high re-admission rate for the ICUs.

OBJECTIVE:In this study, we aimed to assess the effect of the BioFire FilmArray Blood Culture Identification 2 panel on agent identification and antimicrobial stewardship in patients with a critical state of sepsis secondary to bloodstream infection. METHODS:This study was designed as a prospective observational study. Patients who developed sepsis and septic shock secondary to bloodstream infection in the intensive care unit were included in the study. Concordance in both monomicrobial and polymicrobial results of Blood Culture Identification 2 panel and conventional blood culture, test result times, and antibiotherapy changes according to Blood Culture Identification 2 panel results were evaluated. RESULTS:In monomicrobial samples, sensitivity and specificity were 97.1% (95%CI 84.6-99.3) and 100% (95%CI 66.3-100), respectively, for gram-negative pathogens and 85.7% (95%CI 42.1-99.6) and 100% (95%CI 90.2-100), respectively, for gram-positive pathogens. In polymicrobial samples, Blood Culture Identification 2 panel results were 79% in concordance with conventional blood culture results. In this study, when the final turnaround time of the Blood Culture Identification 2 panel was compared with culture results, the Blood Culture Identification 2 panel was on average 1 day, 5 h, and 35 min faster than the culture (p<0.01). CONCLUSION:Blood Culture Identification 2 testing is a reliable tool for rapid pathogen and antimicrobial susceptibility detection in critically ill sepsis patients. The use of the Blood Culture Identification 2 panel in patients with sepsis and/or septic shock, where the transition to targeted antibiotherapy is critical, may improve patient outcomes.

Acute Respiratory Distress Syndrome (ARDS) is an inflammatory condition in the lungs that can be resistant and result in life-threatening respiratory failure. Extracorporeal membrane oxygenation (ECMO) is an alternative treatment option in severe ARDS cases where adequate improvement is not observed with conventional mechanical ventilation.Patients and methodsIn our evaluation, age, gender, comorbidities, causes of ARDS, hospital and intensive care hospitalization times, invasive mechanical ventilation duration, ECMO application times, withdrawal from ECMO and intensive care discharge status of 45 patients who were diagnosed with ARDS and underwent ECMO in the follow-up were analyzed retrospectively. Physical examination, chest X-ray and thorax computed tomography images, PaO2/FiO2 ratios and PEEP values were used for the diagnosis of the patients.Between January 2010–March 2022, SBU Izmir Dr. Suat Seren Chest Diseases and Surgery Hospital, intensive care unit of 45 cases diagnosed with ARDS and applied ECMO in their follow-up were analyzed.ResultsThe mean age of the patients was 46 ± 15.8, of which 35 were male and 10 were female. Apachee – II averages were calculated as 17 ± 8.1. The median IMV time was 23 (range 3–92 days), and the ECMO time was 16 ± 11.1. ECMO support was terminated in 11 (24,4) patients and 8 (17,7) patients were discharged from our hospital with survival.16 of our patients who underwent ECMO were before the COVID-19 pandemic between January 2010 and March 2020. Due to our ARDS cases increasing with the pandemic process, we applied ECMO to 29 of our cases in the last year. We considered and evaluated non-COVID - 19 cases and COVID - 19 cases separately. And patients with COVID-19 had significantly higher Apachee – II averages and Mc Murrey scores, and longer IMV, ECMO, hospital and ICU length of stay compared to the other group. There was no significant difference in mortality between the two groups.ConclusionA significant proportion of ARDS patients (refractory hypoxemia, cardiogenic shock, or septic shock) may require the use of ECMO. Correct application, appropriate patient selection, appropriate follow-up and timing are important in the success of ECMO. While COVID-19 is a serious global health problem with the pandemic process and the number of ARDS cases we encounter has increased significantly, ECMO is of great importance in the treatment of ARDS. As a result, ECMO can be used in ARDS and other indications where conventional therapy has failed.

OBJECTIVE: A 1-day point prevalence study was planned to obtain country data by determining the clinical characteristics, follow-up and treatment methods of coronavirus disease 2019 (COVID-19) cases that required intensive care unit (ICU) treatment in the second year of the pandemic. MATERIAL AND METHODS: All patients who were hospitalized in the ICUs due to COVID-19 between March 11, 2022, 08.00 am, and March 12, 2022, 08.00 am, were included in the study. Demographic characteristics, intensive care and laboratory data, radiological characteristics, and follow-up results of the patients were recorded. RESULTS: A total of 811 patients from 59 centers were included in the study, 59% of the cases were male, and the mean age was 74 ± 14 years. At least one comorbid disease was present in 94% of the cases, and hypertension was the most common. When ICU weight scores were examined, Acute Physiology and Chronic Health Evaluation-II: 19 (15-27) and Sequential Organ Failure Assessment: 7 (4-10) were seen. Sepsis was present in 37% (n = 298) of cases. PaO2/FiO2 ratios of the patients were 190 the highest and 150 the lowest and 51% of the cases were followed via invasive mechanical ventilation. On the study day, 73% bilateral involvement was seen on chest x-ray, and ground-glass opacities (52%) were the most common on chest tomography. There was growth in culture in 40% (n = 318) of the cases, and the most common growth was in the tracheal aspirate (42%). CONCLUSION: The clinical course of COVID-19 is variable, and ICU follow-up was required due to advanced age, comorbidity, presence of respiratory symptoms, and widespread radiological involvement. The need for respiratory support and the presence of secondary infection are important issues to be considered in the follow-up. Despite the end of the second year of the pandemic and vaccination, the high severity of the disease as well as the need for follow-up in ICUs has shown that COVID-19 is an important health problem.

Objective: To compare the effects of a home- based pulmonary rehabilitation (PR) program with and without telecoaching on health- related outcomes in COVID-19 survivors. Methods: A total of 42 COVID-19 patients who completed medical treatment were randomly divided into two groups: the study (telecoaching) group (n = 21) and the control (no telecoaching) group (n = 21). Both groups participated in an 8-week home-based PR program including education, breathing exercises, strength training, and regular walking. The study group received phone calls from a physiotherapist once a week. Both groups of patients were assessed before and after the program by means of the following: pulmonary function tests; the modified Medical Research Council dyspnea scale; the six-minute walk test; extremity muscle strength measurement; the Saint George's Respiratory Questionnaire (to assess disease-related quality of life); the Medical Outcomes Study 36-item ShortForm Health Survey (SF- 36, to assess overall quality of life); and the Hospital Anxiety and Depression Scale. Results: In both groups, there were significant improvements in the following: FVC; the six-minute walk distance; right and left deltoid muscle strength; Saint George's Respiratory Questionnaire activity domain, impact domain, and total scores; and SF-36 social functioning, role-physical, role-emotional, and bodily pain domain scores (p < 0.05). Decreases in daily-life dyspnea, exertional dyspnea, and exertional fatigue were significant in the study group (p < 0.05), and the improvement in SF-36 social functioning domain scores was greater in the study group (p < 0.05). Conclusions: A home- based PR program with telecoaching increases social functioning and decreases daily- life dyspnea, exertional dyspnea, and exertional fatigue in COVID-19 survivors in comparison with a home- based PR program without telecoaching.

Objective:To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey.Methods:COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 >= 5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non-survivors.Results:During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (>= 65 years) and number of comorbid diseases (>= 2) was found to be associated with mortality in nosocomial COVID-19 (OR 1.74, 95% Cl 1.11-2.74 and OR 1.60, 95% Cl 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 (OR 0.25, 95% Cl 0.16-0.38).Conclusions:Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate.

BACKGROUND AND AIM: The long-term outcome of Coronavirus disease 2019 (COVID-19) patients discharged from the intensive care unit (ICU) is unclear. We investigated the effect of COVID-19 on lung structure, pulmonary function, exercise capacity, and quality of life in patients discharged from ICU and medical wards.METHODS: A prospective single-center study was conducted on COVID-19 patients dis-charged from University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital between March 19 and September 1, 2020. Patients who were followed up for more than 48 h in ICU and more than 72 h in medical wards were included in the study. Computed tomography (CT) scores, pulmonary function tests, 6-min walking distance, and health-related quality of life were compared between ICU and medical ward patients 6 months after discharge.RESULTS: A total of 70 patients were included in the final analyses, and 31 of them were dis-charged from ICU. ICU patients had higher CT scores than non-ICU patients at admission (17 vs 11) and follow-up visits (6 vs 0). Two-thirds of ICU patients had at least one abnormal finding on a follow-up CT. Advanced age (OR 1.08, 95% CI 1.02-1.15) and higher CT score at admission (OR 1.13, 95% CI 1.01-1.27) were risk factors for having radiological abnormalities on the follow-up CT. Of the patients discharged from ICU, 90% had at least one persistent symptom.CONCLUSIONS: Many COVID-19 survivors, especially those with severe diseases, could not fully recover even after 6 months after their discharge from the hospital.

Purpose To investigate the intra-rater reliability and the construct validity of the Turkish version of the De-Morton Mobility Index (DEMMI) in intensive care unit (ICU) survivors. Methods Construct validity of the DEMMI was measured by correlating it with physical functioning scales. Known group comparison was made according to the Medical Research Council Sum Score (MRC-SS). Internal consistency was determined by measuring Cronbach alpha coefficient. Test-retest reliability was assessed by performing the DEMMI by the same researcher after 24 h and calculating the intraclass correlation coefficient (ICC). The minimal detectable change (MDC) value was calculated. Results One hundred and two patients discharged from the ICU were included. The ICC for intra-reliability was 0.972. The internal consistency was excellent (Cronbach = 0.991). The DEMMI total score was correlated with the Barthel Index (r = 0.791), Katz Index of Independence in Activities of Daily Living (r = 0.722), MRC-SS (0.614), ICU length of stay (r = -0.515), and total mechanical ventilation duration (r = -0.488). The DEMMI was able to differentiate between MRC-SS subgroups (p < 0.001), whereby higher strength was associated with higher DEMMI scores. The MDC was determined to be 6.82 out of 100 points. Conclusion The Turkish version of the DEMMI is reliable and valid for measuring mobility in ICU survivors.

Background and Objectives: Coronavirus disease-19 (COVID-19) led to respiratory failure and is sometimes complicated with barotrauma. The knowledge about risk factors for the development of barotrauma is scarce and conflict. We aimed to examine the incidence and risk factors for the development of barotrauma in COVID-19 patients who followed up in the intensive care unit (ICU). Materials and Methods: Patients who admitted to ICU from March 15, 2020, to March 31, 2022 were included in the study and retrospectively screened for barotrauma. Patients with barotrauma at ICU admission were excluded from the study. A multiple regression analysis was performed to determine the risk factors for the development of barotrauma. Results: A total of 1113 patients were included in the study, 676 (60.7%) of them were COVID-19. During the study period, at least one barotrauma event was observed in 96 (8.6%) patients. Barotrauma was more common in patients with COVID-19 than non-COVID-19 patients (10.9% vs. 5%, P = 0.001). Positive pressure ventilation was found as the strongest independent risk factor for the development of barotrauma (odds ratio [OR] = 8.80, confidence intervals [CI], 3.88–19.98, P < 0.001). Steroid use also increased the development of barotrauma (OR = 3.45, CI, 1.78–6.67, P = 0.005). Patients with barotrauma had longer length of ICU stay and higher mortality rate than patients without barotrauma. Conclusion: Patients with COVID-19 have a higher risk for the development of barotrauma. Barotrauma is associated with longer ICU stay and increased mortality. Positive pressure ventilation and steroid use are the independent risk factors for barotrauma.

Complicated malaria is caused mainly by Plasmodium falciparum, and increasingly nowadays by Plasmodium vivax. We report a case of vivax malaria complicated by acute respiratory distress syndrome and treated with extracorporeal membrane oxygenation. A 49-year-old patient was operated due to squamous cell carcinoma. After a successful right upper lobectomy operation, he became hypoxemic and developed progressive bilateral lung infiltrates. He had fever, thrombocytopenia and splenomegaly that were not present in the preoperative timeline. A peripheral blood smear verified Plasmodium vivax infection. The patient deteriorated clinically and was intubated. A bronchoscopic evaluation revealed a fistula in the lobectomy stump. Veno-venous extracorporeal membrane oxygenation was initiated due to refractory hypoxemia and to improve healing of the fistula. Our patient expired despite lung protective ventilation and extracorporeal membrane oxygenation support. This case is presented to emphasize the rare occurrence of ARDS and multiple organ failure in Plasmodium vivax infections.

Mechanical ventilation is a lifesaving therapy in patients who have acute respiratory failure due to chronic obstructive pulmonary disease (COPD). Mechanical ventilaton either invasive or non-invasive has an important role in the management of acute exacerbation of COPD (AECOPD). AECOPD required hospitalizaton had increased mortality and poor prognosis. Ventilatory management success related to understanding physiopathology of the disease. Clinicians must be aware of deterioration of clinical signs of COPD patients. The most appropriate treatment should be performed at optimal time. Some COPD patients are at high risk for prolonged mechanical ventilation due to COPD is a progressive disease.

Complicated malaria is caused mainly by Plasmodium falciparum, and increasingly nowadays by Plasmodium vivax.We report a case of vivax malaria complicated by acute respiratory distress syndrome and treated with extracorporeal membrane oxygenation.A 49-year-old patient was operated due to squamous cell carcinoma.After a successful right upper lobectomy operation, he became hypoxemic and developed progressive bilateral lung infiltrates.He had fever, thrombocytopenia and splenomegaly that were not present in the preoperative timeline.A peripheral blood smear verified Plasmodium vivax infection.The patient deteriorated clinically and was intubated.A bronchoscopic evaluation revealed a fistula in the lobectomy stump.Veno-venous extracorporeal membrane oxygenation was initiated due to refractory hypoxemia and to improve healing of the fistula.Our patient expired despite lung protective ventilation and extracorporeal membrane oxygenation support.This case is presented to emphasize the rare occurrence of ARDS and multiple organ failure in Plasmodium vivax infections.

In recent years extracorporeal membrane oxygenation (ECMO) has been used to maintain adequate gas exchange in patients with Acute Respiratory Distress Syndrome (ARDS).The aim of this case report is to share our center's experience with physiotherapy in patients with ARDS on ECMO, to support the use of physiotherapy and to relate the long-term functional outcomes of the patient at six months after discharge.We present here the case of a 28-year-old female who was referred to our intensive care unit with a diagnosis of ARDS being supported by ECMO.While on ECMO, she received physiotherapy interventions including passive techniques, and participated in an active mobility program following ECMO.Her longterm outcomes, including functional level, exercise capacity, dyspnea, muscle strength, anxiety, depression and quality of life, assessed six months after discharge, were at a very good level.We consider that participation in the early physiotherapy and mobility program may contribute to short-and long-term functional improvements in an ECMO patient.