Early rehabilitation program and weaning outcomes in critically ill chronic obstructed airway disease patients: a randomized trial

Background: To compare the effectiveness of early rehabilitation program on mechanical ventilated COPD patient in RICU to those using current usual care regarding diaphragm function and weaning outcomes. Methods: The study was a randomized controlled trial. It included 108 newly admitted COPD patients to RICU, Chest Department, Assiut University Hospital, Egypt, in the period from June 2018 to May 2020. They were divided into two groups: group I received the usual care plus pulmonary rehabilitation program, and group II received the usual care alone. The outcomes (MV duration, rates of successful weaning, diaphragm function, and lengths of hospital and ICU stay) were recorded and evaluated. The data was analyzed using Student t-test, Mann-Whitney U-test, Wilcoxon signed-rank test, chi-square (chi(2)) test or Fisher Exact test, receiver operating characteristics (ROC) curve, and logistic regression analysis. Results: One-hundred and eight COPD patients were included. Early rehabilitation program for COPD patients in the ICU shortened the duration of their MV, increases the rates of successful weaning and decreases 30-day mortality, and shortened the duration of their ICU and hospital stays, as compared to COPD patients who received usual care. Conclusions: Management of COPD patients with early rehabilitation program is associated with better outcome with improvement of the quality of life of COPD patients.