The Effects of High Protein Supplementation, Core Muscle Rehabilitation and Neuromuscular Electrostimulation (NMES) Programs on Clinical Outcomes in Patients with Prolonged Mechanical Ventilation (PMV〕
The goal of this clinical trial is to learn about in patients with prolong mechanical ventilation. This main questions aims to answer are: * High protein formula intake benefit in successful weaning from ventilator * Core muscle rehabilitation benefit in successful weaning from ventilator * neuromuscular electric stimulation benefit in successful weaning from ventilator Participants will receive high protein diet, core muscle rehabilitation, neuromuscular electric stimulation (NMES). Researchers will compare patients with interventions to control group to see if high protein diet, core muscle rehabilitation, neuromuscular electric stimulation works.
• age ≥ 20 year old
• using mechanical ventilator for more than 21 days (including patients under tracheostomy or endotracheal tube)
• stable clinical condition, without using inotropic agent (arterial blood gas pH : 7.35-7.45, PaO2≥60 mm Hg at FiO2 40%, absence of signs and symptoms of uncontrolled infection, and hemodynamic stability)
• maximal inspiratory pressure (MIP) \< 30mmHg
• under enteral nutrition (EN) via NG tube.