The study investigated the effectiveness of lung ultrasound-guided chest physical therapy in patients with invasive mechanical ventilation. 100 patients were included in the research, divided into two groups of 50 each - the control group received therapy according to conventional auscultation and X-ray, the observation group received therapy guided by lung ultrasound. After 3 and 7 days of treatment, the observation group had a significantly lower lung ultrasound score (LUS), indicating better pulmonary ventilation (p < 0.05). Diaphragm function was better at 7 days in the observation group, with greater displacement and rate of thickening (p < 0.05). Blood gases showed a higher partial pressure of oxygen and a better index of oxygenation, at the same time a lower partial pressure of carbon dioxide compared to the control (all p < 0.05). The observation group had a shorter period of mechanical ventilation and ICU stay, while the incidence of complications, such as ventilator-associated pneumonia, was 14% lower (p < 0.05). The results confirm that ultrasound-guided chest physical therapy improves pulmonary ventilation, diaphragm function, and the overall course of treatment in mechanically ventilated patients.