Effectiveness of Nursing Interventions for the Management of Critically Ill Patients With Severe Respiratory Conditions: A Systematic Review and Meta-Analysis
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Yangai Li1, Hui Lyu2, Chaowang Chen3
1Department of General Practice, Handan First Hospital, Handan, China.
Background:
Critically ill patients with severe respiratory conditions frequently require prolonged mechanical ventilation and intensive care, with high risks of complications and death. Nursing interventions may optimise ventilatory care, reduce ICU complications and improve patient outcomes.
Aim:
We synthesised the effectiveness of nursing interventions for managing severe respiratory conditions in ICU settings.
Study Design:
We conducted a systematic review and meta-analysis following PRISMA 2020. Studies evaluating nursing interventions among critically ill adults with severe respiratory conditions in ICUs were included. Outcomes were duration of mechanical ventilation, length of ICU stay, mortality, adverse events and weaning success. Random effects inverse-variance meta-analyses were performed (standardised mean differences [SMD] for continuous outcomes; odds ratios [OR] for binary outcomes).
Results:
Fourteen studies were included. Nursing interventions reduced duration of mechanical ventilation (11 studies; SMD = -1.63, 95% CI -2.29 to -0.96; substantial heterogeneity) and ICU length of stay (10 studies; SMD = -1.25, 95% CI -1.79 to -0.72). Mortality was lower with nursing interventions (5 studies; OR = 0.35, 95% CI 0.21-0.61; I2 = 0%). Adverse events were reduced (9 studies; OR = 0.31, 95% CI 0.22-0.43; low heterogeneity), and weaning success improved (6 studies; OR = 3.17, 95% CI 2.20-4.58; I2 = 0%). Egger's test suggested small-study effects for ventilation duration but not ICU length of stay.
Conclusion:
Nursing interventions in ICU respiratory care improve weaning success and reduce adverse events, mortality, ventilator duration and ICU stay, although effect sizes vary and publication bias is possible for ventilation duration.
Relevance To Clinical Practice:
This review supports the adoption of structured, protocolised nursing interventions, particularly multi-component bundles and targeted nursing plans within respiratory-critical care pathways.
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