Abstract:

Objective To develop a respiratory rehabilitation program suitable for implementation in the early postoperative period in the ICU for patients undergoing cardiopulmonary bypass cardiac surgery. Methods A draft program was developed by synthesizing the best evidence through a systematic literature review. The Delphi method was then used to conduct two rounds of expert consultation with 15 specialists in critical care medicine and critical care nursing from 13 tertiary hospitals in 9 provinces across China，and the final program was established. Results The effective questionnaire recovery rates for the two rounds of Delphi consultation were 93.75% and 100%，respectively. The expert authority coefficients were 0.930 and 0.907，and the variation coefficients of each item were 0-0.13 and 0-0.22. After the second round，Kendall’s coefficient of concordance reached 0.323（P<0.001），indicating convergence of expert opinions. The final program comprises 12 themes and 37 items，covering the entire process of multidisciplinary collaboration，timing of initiation of respiratory rehabilitation，mechanical ventilation management，sedation and analgesia，lung recruitment strategies，respiratory muscle training，early mobilization，nutritional management，and safety monitoring. Conclusion This program is tailored to the ICU setting，specifies initiation of respiratory rehabilitation within 24 hours after surgery，and refines multidisciplinary roles and operational parameters，thereby translating guideline recommendations into executable clinical steps. It demonstrates strong scientific basis，practicality，and operability，and can provide systematic and standardized guidance for early postoperative respiratory rehabilitation in patients undergoing cardiopulmonary bypass cardiac surgery.

Key words: Cardiac Surgery, Cardiopulmonary Bypass, Respiratory Rehabilitation, Delphi Technique, Critical Care Nursing