关键词: 重症监护室；机械通气患者；早期康复；4E模式；护理

Abstract: Objective: To explore the effects of the 4E-based ICU early rehabilitation programme on critically ill patients undergoing mechanical ventilation to provide scientific basis for future clinical practice. Methods: Totally 74 critically ill patients given mechanical ventilation admitted to 2 wards in ICU were recruited by convenience sampling. Patients in Ward 1 was assigned to the experimental group (n=38) and patients in Ward 2 was assigned to the control group (n=36). The control group received routine rehabilitation nursing, while the experimental group received the intervention of early rehabilitation programme based on 4E model. Results: Outcomes including the incidence and duration of ICU delirium, muscle strength scores assessed using Medical Research Council Muscle Strength Grading System, the incidence of Intensive Care Unit Acquired Weakness (ICU-AW), mechanically ventilation duration, duration of ICU stay and the total Length Of Stay (LOS) in hospital of the experimental group were significantly better than those of the control group (P<0.05). No severe early rehabilitation- related adverse events were observed in the experimental group. Conclusion: The early rehabilitation programme based on 4E model is a safe, feasible and effective approach, which can not only improve patients' muscle strength and their activities of daily living, but also reduce the incidence of ICU-AW, decrease the incidence and duration of ICU delirium, and shorten the mechanical ventilation time, ICU stay and the total LOS in hospital.

Key words: ICU; mechanically ventilated patients; early rehabilitation; 4E model; nursing