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Therapeutic effects of different rehabilitation interventions in patients on mechanical ventilation: a systematic evaluation and network meta-analysis

anesthesiology-and-pain-management
emergency-and-critical-care
evidence-based-medicine
rehabilitation

Abstract

This meta-analysis evaluated the effects of early mobilization (EM), electrical stimulation (ES), respiratory muscle training (RMT), prone position (PP), passive cycling exercise (PCE), and comprehensive rehabilitation therapy (CRT) on the prognosis of mechanically ventilated patients.

A systematic search identified relevant studies from four English databases (PubMed, Embase, Web of Science, Cochrane Library) until January 1, 2024. Two reviewers independently extracted data and assessed study quality using the Cochrane risk-of-bias tool. Bayesian network meta-analysis was performed using R Studio and Stata 16, including network plots, funnel plots, and cluster diagrams. 37 RCTs (n=4426) were analyzed. Cumulative probability indicated RMT was best for reducing ventilation duration (78.4%). ES was most effective for shortening ICU stay (80.3%). PP significantly reduced mortality (78.9%). EM (68.4%) and RMT (80.1%) were optimal for decreasing hospital length of stay and improving maximum inspiratory pressure, respectively. Cluster analysis identified RMT as the most beneficial intervention overall.

No single rehabilitation intervention improved all outcomes. RMT is the most recommended approach for enhancing mechanically ventilated patient recovery. Further research should explore combinations of different interventions.

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