Analysis of the effects of a goal-oriented pulmonary rehabilitation training program based on patients with ventilator withdrawal difficulties in the ICU
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: Difficult weaning from mechanical ventilation in ICU patients prolongs hospitalization and increases risks of complications like ventilator-associated pneumonia and ICU-acquired weakness. While standard care (airway management and early functional exercise) is routine, outcomes remain suboptimal. This study evaluated a nurse-led, goal-directed pulmonary rehabilitation program to improve weaning success, reduce weaning time, and enhance physiological/functional recovery in this high-risk population. METHODS: Using convenience sampling, 70 ICU patients with difficult weaning (admitted August 2023-July 2024) were divided into historical control and observation groups (35 each). The control group (August 2023-January 2024) received standard airway care and early functional exercise. The observation group (February-August 2024) received additional nurse-led pulmonary rehabilitation, including individualized goal setting, progressive respiratory training (using continuous positive airway pressure/synchronized intermittent mandatory ventilation protocols), daily sedation-pain-agitation monitoring (Richmond Agitation-Sedation Scale/Care Pain Observation Tool), and muscle strengthening guided by the ICU Mobility Scale. Outcomes compared included weaning success rate, weaning time, oxygenation index (PaO₂/FiO₂), muscle strength (Medical Research Council scale), and self-care ability (Barthel Index), with statistical significance set at P < .05. RESULTS: The observation group demonstrated significantly higher weaning success rates and shorter weaning times versus controls (P < .05). While pre-intervention oxygenation indices showed no difference (P > .05), post-intervention PaO₂/FiO₂ ratios were significantly higher in the observation group (P < .05). Muscle strength (Medical Research Council scores) and self-care ability (Barthel Index scores) also showed statistically significant improvements in the intervention group after treatment (P < .05). CONCLUSION: The nurse-led, goal-directed pulmonary rehabilitation program significantly accelerates weaning, increases success rates, and improves oxygenation, muscle strength, and self-care ability in difficult-to-wean ICU patients. It represents an effective enhancement to standard care and is recommended for broader clinical implementation.
Source: Medicine
Authors: Kaiwen Wang, Shujia Dai
Institution: First Affiliated Hospital of Soochow University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W4413273547