A preventive effect of early and comprehensive pulmonary rehabilitation on pneumonia associated with invasive mechanical ventilation

Abstract

Objective To observe any effect of pulmonary rehabilitation in preventing ventilator-associated pneumonia (VAP) among patients receiving invasive mechanical ventilation (MV). Methods A total of 117 adults who had be receiving mechanical ventilation for at least 48 hours were randomly divided into an observation group and a control group. Both groups were given routine drug treatment and nursing, but the observation group also received comprehensive and individualized pulmonary rehabilitation interventions including airway clearance, respiration training, electrical stimulation of the sacral nerve, lung expansion and early mobilization. The main indicators were the incidence of VAP, mortality, MV duration, ICU stay time, and total hospital stay. Results At the end of the treatment the average clinical pulmonary infection score, the acute physiology and chronic health evaluation II score, SpO2 level and oxygenation index of the observation group were all significantly better than those of the control group. The incidence of VAP within one month after leaving the ICU was 47.5% in the observation group and the mortality rate was 44.1%, both significantly lower than in the control group. The average MV duration, total hospitalization time and the ICU stay of the observation group were also significantly shorter than those of the control group. Conclusion Early and comprehensive pulmonary rehabilitation can prevent VAP and shorten the length of hospital stays, ICU stays and time on a mechanical ventilator, improving patients′ survival chances and prognoses. Key words: Chest physiotherapy; Mechanical ventilation; Ventilator-associated pneumonia; Pneumonia