Early versus Delayed Pulmonary Rehabilitation and Short-Term ICU Outcomes in Mechanically Ventilated Patients

Atika L Qomarianty; Rahmad Rahmad; Samiah Rachmawati; Erinda R Mulia; Bethasiwi Purbasari; Yanuar R Fauzi; Arie Z Fatoni; Irawaty Djaharuddin; Yose Waluyo; Vinny A Damara; Adilla S Purnomo

doi:10.28932/jmh.v8i2.15006

Authors

Atika L Qomarianty Clinical Research Unit, Saiful Anwar General Hospital, Malang, Indonesia https://orcid.org/0009-0001-8397-6185
Rahmad Rahmad Department of Physical Medicine and Rehabilitation, Saiful Anwar General Hospital, Malang, Indonesia; Postgraduate Doctoral Program, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0000-0002-8699-8160
Samiah Rachmawati Department of Physical Medicine and Rehabilitation, Saiful Anwar General Hospital, Malang, Indonesia; Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0009-0009-0773-9231
Erinda R Mulia Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0009-0004-1930-5813
Bethasiwi Purbasari Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0000-0001-6357-3541
Yanuar R Fauzi Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0000-0002-4605-2266
Arie Z Fatoni Faculty of Medicine, Brawijaya University, Malang, Indonesia; Department of Anaesthesiology and Intensive Care, Saiful Anwar General Hospital, Malang, Indonesia https://orcid.org/0000-0002-3314-5586
Irawaty Djaharuddin Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-5240-4950
Yose Waluyo Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-0759-3270
Vinny A Damara Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0009-0009-8945-7827
Adilla S Purnomo Faculty of Medicine, Brawijaya University, Malang, Indonesia https://orcid.org/0000-0001-8833-3739

DOI:

https://doi.org/10.28932/jmh.v8i2.15006

Keywords:

pulmonary rehabilitation, early rehabilitation, mechanical ventilation, intensive care unit, length of stay

Abstract

Mechanical ventilation is a life-saving intervention in the intensive care unit (ICU), yet it is commonly associated with prolonged immobilization, muscle weakness, and delayed recovery. Pulmonary rehabilitation (PR) has been applied to reduce these complications, although the optimal timing of its initiation in mechanically ventilated patients remains unclear. This study aimed to compare short-term ICU outcomes, including duration of mechanical ventilation and ICU length of stay, between patients receiving early and delayed PR. A retrospective cohort study was conducted using medical records of adult ICU patients who received pulmonary rehabilitation during mechanical ventilation from January to December 2024. Patients were grouped into early PR (≤ 48 hours after ICU admission) and delayed PR (> 48 hours). Baseline characteristics assessed included age, sex, primary diagnosis, and SOFA score. In total, 110 patients were included, with 27 in the early PR group and 83 in the delayed PR group. Baseline characteristics were generally comparable between groups. The early PR group experienced significantly shorter duration of mechanical ventilation (p < 0.001) and reduced ICU length of stay (p < 0.001) compared to the delayed PR group. These findings indicate a potential association between early pulmonary rehabilitation and short-term ICU outcomes.

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