Testing the prognostic value of the rapid shallow breathing index in predicting successful weaning in patients requiring prolonged mechanical ventilation

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• 作者：Avelino C. Verceles ; MD^a ; ^{Avercele@medicine.umaryland.edu} ; Montserrat Diaz-Abad ; MD^a ; Jeanne Geiger-Brown ; PhD ; RN^b ; Steven M. Scharf ; MD ; PhD^a
• 关键词：Mechanical ventilation ; Prolonged mechanical ventilation ; Rapid shallow breathing index ; Respiratory failure ; Spontaneous breathing trial ; Weaning
• 刊名：Heart Lung: The Journal of Acute and Critical Care
• 出版年：2012
• 出版时间：November-December, 2012
• 年：2012
• 卷：41
• 期：6
• 页码：546-552
• 全文大小：375 K

文摘

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 ¡Ü 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 ¡À 14.2 vs 99.3 ¡À 30.2, P = .007; 71.7 ¡À 31.2 vs 123.3 ¡À 92.5, P = .005, respectively). RSBI variability and rate of change were different between groups (coefficient of variation, .37 ¡À .12 vs .51 ¡À .30, P = .02, rate of change: ?3.40 ¡À 9.40 vs 4.40 ¡À 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.