Study population
pneumothorax, preexisting neuromuscular lesions, respiratory failure, infection, skin damage
RESPIRATORY FAILURE, INFECTION, PNEUMOTHORAX, MOVEMENT DISORDERS
This is a prospective randomized controlled study that conducted in the 32-bed medical ICU of a 2000-bed medical center in Affiliated Hospital of Qingdao University between February 2022 and September 2022. Patients on MV for respiratory failure were assigned to study group and control group randomly through a computer-generated allocation order. The study group adopted the method of NMES combined with early rehabilitation while those in the control group underwent regular rehabilitation without the application of NMES (Fig. 
The weaning program All patients will be evaluated daily from 7:00am to 12:00am. Postoperative patients will be evaluated at any time according to their conditionThe inclusion criteria were as follows: (1) Patients were expected to require MV > 72 h; (2) Patients and their relatives had written informed consent. The exclusion criteria:(1) Pregnancy; (2) Patients with preexisting neuromuscular lesions; (3) Patients with unrelieved pneumothorax and restricted diaphragm movement disorders; (4) Chest or diaphragm malformation; (5) Patients who cannot attach electrodes due to local skin damage or infection; (6) Patients with implanted pacemakers; (7) Patients that with a body mass index > 35 kg/mThe ICU team rounds were made at least once a day, and doctors remain on duty 24 h a day. The ratio of patients to intensivists was 3:1 and the ratio of patients to nurses was 1:2. The ICU has a specialized rehabilitation technician, but not a respiratory therapist. The decision to remove endotracheal intubation was made by clinicians according to clinical experience and the weaning process, which was shown in Fig. 
Flow diagram of the studyThis study was approved by the Ethics Committee of the Affiliated Hospital of Qingdao University (No.QYFYWZLL26720) and has been registered at clinicaltrials.gov. with trial registration number NCT05217511.