It is widely recognized that the intensive care unit (ICU) is a different environment from that in which pulmonary rehabilitation (PR) services are provided. Pulmonary rehabilitation typically involves patients with stable chronic disease, who are most often treated on an outpatient basis, while the intensive care unit is occupied by critically ill patients who present with multiple dynamic medical or surgical problems. However, some patients admitted to the ICU also suffer from body deconditioning, neuropathy, myopathy, body weakness, increased length of ICU stay, prolonged ventilatory support, delayed weaning, and prolonged pulmonary rehabilitation after hospitalization. USI (Schweickert and Hall, 2007). MacIntyre pointed out that approximately 40% of intensive care patients receive ventilatory support due to acute illness complicating chronic illness and that the frequency of mechanical ventilation also appears to be increasing (MacIntyre et al., 2005). Additionally, some patients requiring prolonged mechanical ventilation become ventilator dependent. In intensive care, the need for pulmonary rehabilitation has become obvious for all ventilated or non-ventilated patients. Starting pulmonary rehabilitation in the intensive care unit (ICU) is an important instrument to optimize the use of resources, prevent and treat certain complications of intensive care and to facilitate, improve long-term recovery and decrease the patient's dependence on the ventilator mechanical. In this article, I will review strategies for starting pulmonary rehabilitation in the ICU. Definition “Pulmonary rehabilitation is an evidence-based, comprehensive, multidisciplinary intervention for patients with chronic respiratory diseases who are symptomatic and often have a reduction in activities of daily living. Integrated into individualized patient treatment, pulmonary rehabilitation is designed to reduce symptoms, optimize functional status, increase participation, and reduce health care costs by stabilizing or reversing systemic disease manifestations” (Carlin, 2009 ; L. Nici et al., 2006). This definition focuses on a significant number of factors that may influence the patient's health and care resources. These factors are the multidisciplinary approach, individualized treatment of the patient and attention to physical, social and health costs (Ries, 2008). The scope of pulmonary rehabilitation All patients with stable chronic lung disease and disabled by respiratory diseases are candidates for pulmonary rehabilitation (Ries, 2008). The intensive care unit (ICU) is an extremely specialized, busy, and expensive area compared to the outpatient pulmonary rehabilitation program. However, critically ill patients admitted to the intensive care unit (ICU) most often suffer from severe manifestations of deconditioning and immobility. The causes of admissions to intensive care units (ICU) are varied and