Critical Care: Mechanical Ventilation & Respiratory Failure I |

Rapid Shallow Breathing Index Rate as a Predictor of Weaning Outcome During Spontaneous Breathing Trial: A Cohort Study FREE TO VIEW

George Paul Habacon; Edgardo Tiglao; Teresita DeGuia; William Del Poso; Maria Encarnita Limpin
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Philippine Heart Center, Taytay, Philippines

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):303A. doi:10.1016/j.chest.2016.08.316
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SESSION TITLE: Mechanical Ventilation & Respiratory Failure I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Rapid shallow breathing index (RSBI) is commonly used clinically for predicting the outcome of weaning from mechanical ventilation. However, studies have shown that a single RSBI determination does not reflect the entire weaning process. The aim of the study was to evaluate the measure of RSBI change or RSBI rate as a predictor of weaning outcome during a spontaneous breathing trial and compare it with other weaning parameters.

METHODS: The study was a single-center prospective cohort analysis consisting of 71 subjects. After meeting the criteria for weaning and normal weaning parameters, spontaneous breathing trial (SBT) was started. RSBI was determined on the first and 30th minute of a spontaneous breathing trial. RSBI rate was computed based on the formula: [(RSBI1st - RSBI30th)/RSBI1st] x 100. Weaning success or failure was then ascertained.

RESULTS: Weaning was successful in 59 patients and failed in 12 patients. Among those with weaning failure, 4 patients required reinstitution of mechanical ventilation within 48 hours, 3 patients required noninvasive ventilation after extubation and 5 patients could not be extubated after SBT. RSBI rate significantly predicts weaning outcome (p=<0.001) with a sensitvity of 100% and specificity of 81.36%. Also, RSBI rate (AUC 0.94) shows superior predictive power than static compliance (AUC 0.48), dynamic compliance (AUC 0.34) and single RSBI (AUC 0.37).

CONCLUSIONS: This study further proves that the use of the RSBI rate, which is a dynamic measure of lung mechanics, is an accurate predictor of weaning outcome and even more reliable than other weaning parameters such as lung static and dynamic compliance and single RSBI determination.

CLINICAL IMPLICATIONS: With the use of RSBI rate, which better predicts the weaning outcome, it can prevent delay in extubation and lessen ventilator-related complications such as pneumonia, airway trauma and need for tracheostomy. In the process, it will also minimize patients’ hospital expenses, morbidity and mortality.

DISCLOSURE: The following authors have nothing to disclose: George Paul Habacon, Edgardo Tiglao, Teresita DeGuia, William Del Poso, Maria Encarnita Limpin

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