Effect of Pulmonary Rehabilitation on Patients’Outcome After Extubation: A Randomized Controlled Trial

Background: To evaluate whether pulmonary rehabilitation can improve respiratory function and life quality of the patients who were removed from invasive mechanical ventilation in the ICU and sequentially treated with high-flow humidification therapy instrument. Methods: : This study is a single-center clinical randomized controlled trial. Selected from April 2019 to April 2020, 53 patients who were sequentially treated with High-Flow Humidification Device after extubation in the ICU were randomly divided into two groups. The experimental group received pulmonary rehabilitation treatment, while the control group received only conventional treatment. All patients were then evaluated for rehabilitation and bedside diaphragm ultrasound measurement. Results: : Compared with the control group, experimental group’s incidences of non-invasive ventilation use, re-intubation and complication were significantly reduced (P <0.05), yet there was no significant reduction of two groups’ mortality rate (P = 0.3). The experimental group's MRCsum (Medical Research Council sum) muscle strength score, 30-second sit-up test parameter, and modified Barthel index all presented significant difference (P <0.05). The degree of diaphragm movement, end-inspiratory diaphragm thickness and diaphragm thickness variation rate were significantly increased (P <0.05). Conclusions: : Pulmonary rehabilitation is safe with certain efficacy. It is of great significance to the enhancement of patient's peripheral muscle strength and endurance, respiratory function, and daily life activities. It can reduce the incidences of non-invasive ventilation use and re-intubation and help patients return to their families and society better. Nevertheless, the current development of pulmonary rehabilitation is not perfect. Subsequent research of a multi-center randomized controlled trial should be conducted to further explore the efficacy of pulmonary rehabilitation, promote the spread of pulmonary rehabilitation technics, and provide home-based rehabilitation guidance and long-term follow-up for discharged ICU patients. Trial registration: Clinical trial registration number: NCT04368286; Ethics number: S2018-212-01. Subject ①Number: 2018FC-WJFWZX-2-04. ②Chinese PLA Health Care Grant: 17BJZ35.