总结1例呼吸衰竭继发脱机相关性心力衰竭患者肺康复的护理体会。针对患者脱机困难、心力衰竭等问题，护理要点包括以护士为主导，组建多学科肺康复管理团队；急性期平衡呼吸支持与心脏负荷，优先改善心功能，精细化容量管理；康复期行“三阶式心功能预警”脱机训练，序贯式镇静镇痛，实施个体化肺康复。经精心护理，患者在住院第48天成功撤除呼吸机，转至普通病房；住院第62天康复出院。

To summarize the nursing experience of pulmonary rehabilitation in a patient with respiratory failure secondary to weaning failure of cardiac origin. In response to issues such as difficulty in weaning and heart failure，nursing points included nurse-led establishment of a multidisciplinary pulmonary rehabilitation management team，balancing respiratory support and cardiac load during the acute phase，prioritizing cardiac function improvement，and refined volume management. During the rehabilitation period，offline training with “three-stage cardiac function warning” was performed，sequential sedation and analgesia，and personalized lung rehabilitation were implemented. After careful care，the patient successfully removed the ventilator on the 48th day of admission and was transferred to a regular ward. He was discharged on the 62nd day.