Abstract
This retrospective cohort study, conducted at People's Hospital of Wenjiang Chengdu (January 2018 to January 2022), aimed to evaluate the effects of early pulmonary rehabilitation (PR) on respiratory function in acute respiratory distress syndrome patients after discontinuing invasive mechanical ventilation in the intensive care unit. Patients were divided into PR and control groups based on an offline training protocol. Outcome measures included short physical performance battery scores, respiratory muscle strength, and pulmonary function indicators at discharge and 3 months post-discharge, including peak expiratory flow, forced expiratory volume in 1 second/forced vital capacity, and vital capacity. Kaplan-Meier analysis assessed 6-month survival rates. Among the 240 patients, 120 received traditional training and 120 received early PR. Both groups had no significant differences in baseline characteristics. Short physical performance battery scores and respiratory muscle strength showed gradual improvements in both groups, with the PR group achieving significantly higher scores at 5 and 7 days (P < .05). At 3 months post-discharge, pulmonary function indicators such as peak expiratory flow, forced expiratory volume in 1 second/forced vital capacity, and vital capacity in the PR group were significantly improved compared to discharge and were higher than those in the control group (P < .05). The number of sputum aspirations in the PR group significantly decreased (P < .05), and intensive care unit stays after weaning were significantly shorter (P < .05). Kaplan-Meier survival analysis revealed that the cumulative survival rate at 6 months post-discharge was significantly higher in the PR group compared to the control group (hazard ratio = 0.660, 95% CI: 0.472-0.922, P = .014). These findings suggest that early PR significantly enhances respiratory function recovery, reduces complications, and improves survival outcomes in acute respiratory distress syndrome patients after invasive ventilation.