Prospective care in prevention of ICU acquired weakness in mechanically ventilated patients

ZHANG Jinping; TAO Yu

doi:10.3969/j.issn.2097-1753.2025.01.019

Abstract：Objective To explore the role of prospective nursing in preventing ICU-acquired weakness (ICU-AW) in patients receiving mechanical ventilation. Methods A total of 67 patients receiving mechanical ventilation at the Department of Respiratory and Critical Care Medicine, Nanjing Hospital affiliated with Nanjing Medical University, from August 2022 to December 2023 were selected. They were randomly divided into a control group (n=33) and a study group (n=34). The control group received routine nursing care, while the study group received prospective nursing in addition to routine care. The Medical Research Council Muscle Strength (MRC) scale was used to compare muscle strength between the two groups. The Activity of Daily Living (ADL) scale and the Barthel Index (BI) were used to assess daily living abilities. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate anxiety and depression levels. The duration of mechanical ventilation and hospitalization time were also recorded. Results There was no statistically significant difference in MRC scores between the two groups before nursing (P>0.05). The difference in MRC scores before and after nursing in the study group was higher than that in the control group, with a statistically significant difference (t=4.082, P<0.001). There was no statistically significant difference in ADL scores between the two groups before nursing (P>0.05). The difference in ADL scores before and after nursing in the study group was higher than that in the control group, with a statistically significant difference (t=8.906, P<0.001). There was no statistically significant difference in BI scores between the two groups before nursing (P>0.05). The difference in BI scores before and after nursing in the study group was higher than that in the control group, with a statistically significant difference (t=2.386, P=0.036). There was no statistically significant difference in SAS and SDS scores between the two groups before nursing (P>0.05). The differences in SAS and SDS scores before and after nursing in the study group were both higher than those in the control group, with statistically significant differences (t=5.064, 5.238, P<0.001 for both). The duration of mechanical ventilation in the study group was shorter than that in the control group (t=11.063, P<0.001), and the average hospitalization time in the study group was also shorter than that in the control group (t=10.169, P<0.001). Conclusion Prospective nursing can effectively prevent ICU-AW, improve patients' self-care ability, and alleviate their anxiety and depressive psychological state, thereby reducing the duration of mechanical ventilation and hospitalization time. It is worth further research and promotion in clinical practice.