Effect of integrated nursing on serum inflammatory factors and oxygenation indices in children with severe respiratory failure: A prospective quasi-experimental controlled study

This study aimed to evaluate the effects of an integrated nursing model on systemic inflammation, oxygenation, and clinical outcomes in children with severe respiratory failure. Children with severe respiratory failure requiring invasive mechanical ventilation for ≥72 hours were consecutively enrolled. Participants were allocated according to admission period into a routine nursing group (2023) and an integrated nursing group (2024-2025). The integrated nursing model involved multidisciplinary assessment, coordinated care planning, and continuous nursing evaluation. Primary outcomes included changes in inflammatory markers (interleukin-6, tumor necrosis factor alpha, and C-reactive protein), while secondary outcomes included oxygenation indices (PaO2/FiO2), duration of mechanical ventilation, pediatric intensive care unit length of stay, and complications. Data were analyzed using independent-sample tests, chi-square tests, and linear mixed-effects models. Compared with routine nursing, integrated nursing was associated with greater reductions in interleukin-6, tumor necrosis factor alpha, and C-reactive protein over time and faster improvements in oxygenation indices. The integrated care group also had shorter mechanical ventilation duration and pediatric intensive care unit length of stay, and a lower incidence of ventilator-associated pneumonia. Integrated nursing may improve inflammatory control, oxygenation, and clinical outcomes in critically ill children with severe respiratory failure. Further multicenter randomized studies are warranted.