Clinical effect of pulmonary rehabilitation in patients with mechanical ventilation: A meta-analysis

医学 机械通风 重症监护室 荟萃分析 康复 科克伦图书馆 置信区间 肺康复 深静脉 入射(几何) 相对风险 严格标准化平均差 重症监护医学 内科学 物理疗法 血栓形成 物理 光学
作者
Yang Yang,Rong-Ju Zhang,Xi-Na Yuan,Yue-Qin Gu,Yongnan Li,Shuping S. Wu,Yan-Shuang Cheng
出处
期刊:International Journal of Artificial Organs [SAGE Publishing]
卷期号:47 (2): 96-106
标识
DOI:10.1177/03913988231218116
摘要

Objective: To systematically evaluate the clinical efficacy of pulmonary rehabilitation in patients with mechanical ventilation in an intensive care unit (ICU). Methods: Relevant studies were identified in the PubMed, Web of Science, National Library of Medicine, China National Knowledge Infrastructure and Wanfang databases. A meta-analysis was performed after screening based on the inclusion and exclusion criteria, data extraction and literature quality evaluation. Results: In total, 19 studies involving 2181 participants were included. The results of the meta-analysis revealed that compared with patients with conventional rehabilitation measures, patients with pulmonary rehabilitation measures had a higher offline success rate (relative risk (RR) = 1.16; 95% confidence interval (CI): 1.09, 1.24; p < 0.00001) and higher arterial oxygen partial pressure levels (mean difference (MD) = 8.96; 95%CI: 5.98, 11.94; p < 0.0001) and these measures significantly shortened the duration of mechanical ventilation (standardised MD (SMD) = −1.08; 95%CI: −1.58, −0.59; p < 0.0001) and ICU stay (SMD = −1.41; 95%CI: −1.94, −0.88; p < 0.0001). Aspiration significantly reduced the incidence of ventilator-associated pneumonia (RR = 0.35; 95%CI: 0.24, 0.51; p < 0.00001) and deep vein thrombosis (RR = 0.32; 95%CI: 0.13, 0.76; p = 0.01) in ICU patients with mechanical ventilation. Conclusion: Pulmonary rehabilitation measures can improve the success rate of weaning from mechanical ventilation in ICU patients, shorten the time of mechanical ventilation and ICU hospitalisation and reduce the incidence of related adverse reactions, but the impact on mortality requires further study.
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