title: [The Effectiveness of Pulmonary Rehabilitation for Critical-Care Ventilator Patients: A Systematic Review].
abstract: BACKGROUND
  Prolonged of use mechanical ventilators results in respiratory muscle atrophy and difficulties in weaning, which increase mortality rates and psychlogical distress. While pulmonary rehabilitation has been shown to improve respiratory muscle strength, the effects of this intervention in critical-care patients who use mechanical ventilation remain uncertain.
  
  
  OBJECTIVE
  The present paper uses a systematic review of the literature to evaluate the effects of pulmonary rehabilitation on the rate of ventilator weaning and on the physical performance of ventilator patients receiving critical care.
  
  
  METHODS
  A systematic review was used. Searches were conducted in databases including: Cochrane Library, Embase, MEDLINE, PubMed and Airit Library. Keywords that were used included: "mechanical ventilation", "pulmonary rehabilitation", "exercise", "weaning", and "activities of daily living". The search focused on articles that were published prior to February 2015. Based on inclusion and exclusion criteria, 7 articles addressing relevant randomized controlled trials were extracted.
  
  
  RESULTS
  All of the 7 studies supported that pulmonary rehabilitation interventions improve mechanical ventilation weaning and functional independence activities. Several studies were limited by small sample size and differences in the types of rehabilitations used. Thus, the generalizability of the findings of this review is limited. and further research is required to verify the effects of pulmonary rehabilitation.
  
  
  CONCLUSIONS
  The results of this systematic review support that pulmonary rehabilitation interventions improved the weaning rate, activities of functional independence, and maximal inspiratory pressure (MIP) in critical patients who had used mechanical ventilators for over 48 hours. Under hemodynamic-stablized and pressure-support mode, inspiratory muscle training is suggested as useful for patients with limited ability to participate in rehabilitation programs.
authors.affiliation: BSN, RN, Head Nurse, Department of Nursing, Chang Gung Medical Foundation at Linkou Branch, Taiwan, ROC.
authors.forename: Min-Shan
authors.initials: MS
authors.lastname: Chung
authors.affiliation: BSN, RN, Head Nurse, Department of Nursing, Chang Gung Medical Foundation at Linkou Branch, Taiwan, ROC.
authors.forename: Chi-Chin
authors.initials: CC
authors.lastname: Huang
authors.affiliation: MSN, RN, Supervisor, Department of Nursing, Chang Gung Medical Foundation at Linkou Branch, and Adjunct Instructor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Yeh
authors.affiliation: MSN, RN, Supervisor, Department of Nursing, Chang Gung Medical Foundation at Linkou Branch, and Adjunct Instructor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
authors.forename: Yueh-E
authors.initials: YE
authors.lastname: Lin
authors.affiliation: MSN, RN, Deputy Director, Department of Nursing, Chang Gung Medical Foundation at Linkou Branch, and Adjunct Instructor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC.
authors.forename: Lun-Hui
authors.initials: LH
authors.lastname: Ho
authors.affiliation: PhD, RN, Professor, Department of Nursing, Chang Gung University of Science and Technology, and Adjunct Consultant, Department of Nursing, Chang Gung Medical Foundation at Linkou Branch, Taiwan, ROC. shuching@gw.cgust.edu.tw.
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000203:Activities of Daily Living; D003422:Critical Care; D006801:Humans; D012121:Respiration, Artificial; D015300:Ventilator Weaning
keywords: critical patients; mechanical ventilation; pulmonary rehabilitation; systematic review; weaning