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

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.