Does impermeable to pathogens and fluids mean that the mattress will not be able to breathe?

Not at all. The barrier will not allow pathogens or fluids to pass from the patient to the mattress or the mattress to the patient. However, it does allow water vapor molecules to pass through in order to maintain an ideal microclimate.63

References

63. Wound Care. Trinity Guardion. https://trinityguardion.com/resources/wound-care/. Accessed April 15, 2021.