The effect of early rehabilitation on therapeutic outcomes in ICU patients on mechanical ventilation: A meta-analysis.

IF 1.4 4区医学 Q4 ENGINEERING, BIOMEDICAL International Journal of Artificial Organs Pub Date : 2025-01-08 DOI:10.1177/03913988241311816

Saisai Li, Xiulu Xu, Jingjing Hu, Yuexia Wang

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Abstract

Objective: To evaluate the effect of early rehabilitation on therapeutic outcomes of patients in the ICU requiring mechanical ventilation.

Methods: Electronic databases up to June 15, 2024 were searched. Randomized controlled trials (RCTs) that compared early rehabilitation with standard rehabilitation for patients in the ICU on mechanical ventilation were included. The effects of early rehabilitation on outcomes such as duration of mechanical ventilation (days), ICU length of stay (days), hospital length of stay (days), ICU and in-hospital mortality, and ICU-acquired weakness (ICU-AW) were evaluated using a random-effects model.

Results: Nineteen RCTs met the inclusion criteria for this study, involving 3076 patients in the ICU on mechanical ventilation. Meta-analysis based on the random-effects model showed that early rehabilitation significantly reduced the duration of mechanical ventilation, ICU-AW risk, ICU length of stay, and total hospital length of stay. Analysis of the timing of early rehabilitation indicated that implementing early rehabilitation within ⩽48 or ⩽72 h after ICU admission or mechanical ventilation had varying effects on the duration of mechanical ventilation, ICU length of stay, and total hospital length of stay.

Conclusion: Early rehabilitation can improve the therapeutic outcomes for ICU patients on mechanical ventilation. The optimal time for implementing early rehabilitation appears to be 48-72 h after ICU admission or initiation of mechanical ventilation, but further research is needed.

Clinical trial number: INPLASY202470068.

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早期康复对ICU机械通气患者治疗结果的影响：一项meta分析。

目的：探讨早期康复对ICU机械通气患者治疗效果的影响。方法：检索截至2024年6月15日的电子数据库。纳入了比较ICU机械通气患者早期康复与标准康复的随机对照试验（RCTs）。采用随机效应模型评估早期康复对机械通气持续时间（天）、ICU住院时间（天）、住院时间（天）、ICU和院内死亡率以及ICU获得性虚弱（ICU- aw）等结局的影响。结果：19项rct符合本研究的纳入标准，共纳入ICU机械通气患者3076例。基于随机效应模型的meta分析显示，早期康复显著降低机械通气时间、ICU- aw风险、ICU住院时间和总住院时间。早期康复时间分析表明，在ICU入院或机械通气后≥48 h或≥72 h内实施早期康复对机械通气时间、ICU住院时间和总住院时间有不同的影响。结论：早期康复治疗可提高ICU机械通气患者的治疗效果。早期康复的最佳时间为入住ICU后48-72 h或开始机械通气，但仍需进一步研究。临床试验号：INPLASY202470068。

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来源期刊

International Journal of Artificial Organs 医学-工程：生物医学

CiteScore

3.40

自引率

5.90%

发文量

审稿时长

3 months

期刊介绍： The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.