Multidisciplinary collaborative approach to cardiopulmonary rehabilitation in cancer patients with intensive care unit-acquired weakness: a clinical efficacy and safety analysis

针对重症监护室获得性肌无力癌症患者,采用多学科协作方法进行心肺康复:一项临床疗效和安全性分析

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Abstract

OBJECTIVES: To evaluate the efficacy and safety of a multidisciplinary team (MDT)-based cardiopulmonary rehabilitation model in patients with intensive care unit-acquired weakness (ICU-AW). METHODS: Between January 2020 and June 2023, 80 ICU patients were enrolled: 40 received standard cardiopulmonary rehabilitation (control group), and 40 underwent MDT-based rehabilitation (observation group). Outcome measures included ICU-AW incidence, muscle strength Medical Research Council (MRC) scores, upper/lower limb strength, Barthel Index Sequential Organ Failure Assessment (SOFA) Acute Physiology and Chronic Health Evaluation (APACHE) II scores, duration of ICU and hospital stay, mechanical ventilation time, complications, and patient satisfaction. Predictive variables for ICU-AW were also analyzed. RESULTS: On days 4 and 7 post-intervention, ICU-AW incidence was significantly lower in the observation group (both P < 0.05). MRC scores, limb muscle strength, Barthel Index, and satisfaction were significantly higher in the observation group (all P < 0.05), while SOFA, APACHE II scores, ICU stay, hospital stay, and ventilation duration were significantly lower (all P < 0.05). SOFA scores declined from day 5, with lower values in the observation group (P < 0.05). The risk of ICU-AW in the observation group was a significant reduction in risk than in the control group (OR = 0.067, 95% CI: 0.005-0.606, P = 0.017). No significant differences in complications were observed (P > 0.05). CONCLUSIONS: MDT-based cardiopulmonary rehabilitation significantly improves muscle strength, functional status, and patient satisfaction, while reducing ICU-AW incidence, ICU and hospital stay, and ventilation duration. These findings support its broader clinical application in ICU-AW management.

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