Testing the prognostic value of the rapid shallow breathing index in predicting successful weaning in patients requiring prolonged mechanical ventilation.
Heart Lung 2012;
41:546-52. [PMID:
22770598 DOI:
10.1016/j.hrtlng.2012.06.003]
[Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 06/04/2012] [Accepted: 06/05/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE
The study objective was to assess the prognostic value of the rapid shallow breathing index (RSBI) in predicting successful weaning of patients from prolonged mechanical ventilation (PMV) in long-term acute care (LTAC) facilities. The RSBI predicts successful ventilator weaning in acutely ill patients. However, its value in PMV is unclear.
METHODS
A retrospective cohort study of patients receiving PMV in LTAC facilities was performed. RSBI was measured daily, with weaning per protocol. Initial, mean, and final RSBI; RSBI ≤ 105; rate of change; and variability were assessed.
RESULTS
Twenty-five of 52 patients were weaned from PMV. Only the mean RSBI and the RSBI on the last day of weaning predicted success (78.7 ± 14.2 vs 99.3 ± 30.2, P = .007; 71.7 ± 31.2 vs 123.3 ± 92.5, P = .005, respectively). RSBI variability and rate of change were different between groups (coefficient of variation, .37 ± .12 vs .51 ± .30, P = .02, rate of change: -3.40 ± 9.40 vs 4.40 ± 11.1 RSBI points/day, P = .005, weaned vs failed).
CONCLUSION
Although isolated RSBI measurements do not predict successful weaning from PMV, RSBI trends may have prognostic value.
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