PURPOSE: The Rapid Shallow Breathing Index (RSBI), as measured by Yang and Tobin in 1991, has long been the gold standard for assessment of a patients’ readiness to be weaned from the ventilator. There is little data regarding collection via hand-held spirometer vs. collection via mechanical ventilator.
METHODS: An RSBI via each method was observed 15 minutes apart for each sample during weaning assessment. During hand-held spirometer assessment, the patient was removed from the ventilator and placed on the spirometer with a one-way valve. The first 30 seconds of spontaneous breathing were discarded, and the spirometer was reset. The practitioner then recorded the respiratory rate and minute volume for the next 60 seconds.During assessment via mechanical ventilator, the ventilator mode was changed to CPAP, and pressure support was set to 0. The first 60 seconds of spontaneous breathing were discarded. The practitioner then recorded the respiratory rate and minute volume for the next 2 minutes.
RESULTS: After performing a total of 38 observations using both methods, we analyzed the results using the paired t-test, Peason correlation coefficient, and Spearmans’ rho methodologies. There was a positive correlation between hand-held spirometer scores and ventilator scores for both Peason Correlation coefficient (.77) and Spearmans’ rho (.69). We did not observe any statistically significant differences in scores between the two groups.
CONCLUSION: RSBI results were unaffected by choice of method in this study. The high positive correlation and lack of statistically significant differences between the two collection methods illustrate the ability of current technology to measure RBSI accurately through a mechanical ventilator.
CLINICAL IMPLICATIONS: Measurement of the RSBI via mechanical ventilator may allow clinicians to address the issues of cost management, patient safety and infection control while maintaining the reliability and reproducibility of an index considered to be a clinical standard since 1991.
DISCLOSURE: Joan Cecich, No Financial Disclosure Information; No Product/Research Disclosure Information