Objective To study the clinical application effect of intelligent communication based on WeChat applet in ICU mechanically ventilated patients.Methods Forty mechanically ventilated awake patients admitted to the emergency care unit from August 2023 to February 2024 were selected as a control group, and conventional nurse-patient communication methods were used, and forty mechanically ventilated awake patients admitted to the emergency care unit from March to September 2024 were selected as an intervention group, and the intelligent communication based on WeChat applet was used for nurse-patient communication.The communication effects, communication barriers, anxiety, depression, and delirium incidence rates of the two groups were compared.Results After the intervention, the degree of communication barriers, anxiety and depression scores, and incidence of delirium in the intervention group were significantly lower than those in the control group （all P＜0.05）, and the nurse-patient communication effect score in the intervention group was significantly higher than that in the control group （P＜0.05）.Conclusion The implementation of WeChat applet-based intelligent communication for ICU mechanically ventilated patients can improve nurse-patient communication effects, alleviate patients′ negative emotions, and decrease their incidence of delirium.