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Editorials |

Weaning Parameters : Read the Methodology Before Proceeding

Bruce P. Krieger, MD, FCCP; Michael Campos, MD
Author and Funding Information

Affiliations: Miami, FL
 ,  Dr. Krieger is Professor of Medicine, University of Miami at MSMC, and Director, Medical Intensive Care Units, Mount Sinai Medical Center, Miami Beach; Dr. Campos is Chief Fellow, Division of Pulmonary and Critical Care Medicine, University of Miami.

Correspondence to: Bruce P. Krieger, MD, FCCP, Pulmonary Division, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140; e-mail: bronchobruce@pol.net



Chest. 2002;122(6):1873-1874. doi:10.1378/chest.122.6.1873
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The “perfect” weaning parameter remains elusive, although the clinically accepted standard over the past decade has been the rapid shallow breathing index (RSBI) of Yang and Tobin.1 Other investigators have questioned the sensitivity, specificity,23 and accuracy of the RSBI as determined by receiver operating characteristic curves.4 However, these studies did not duplicate the methodology of Yang and Tobin,1 who measured the RSBI using a hand-held, calibrated spirometer connected to the patient by a T-piece set up for 60 s. Rather, measurements were made with patients receiving continuous positive airway pressure (CPAP) and/or with pressure support being applied. Even when the methodology of Yang and Tobin was duplicated, we5 showed that the threshold value for RSBI differed depending on the population being studied.

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