Etiology of extubation failure and the predictive value of the rapid shallow breathing index.

1995 ◽  
Vol 152 (2) ◽  
pp. 545-549 ◽  
Author(s):  
S K Epstein
Keyword(s):  
Predictive Value ◽  
Extubation Failure ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

Predictors of extubation failure after open-chest cardiac surgery based on routinely collected data. The importance of a shared interprofessional clinical assessment

2018 ◽  
Vol 17 (8) ◽  
pp. 751-759 ◽  
Author(s):  
Gianfranco Sanson ◽  
Massimiliano Sartori ◽  
Lorella Dreas ◽  
Roberta Ciraolo ◽  
Adam Fabiani
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Invasive Mechanical Ventilation ◽  
Extubation Failure ◽  
Hospital Length ◽  
Neurological Function ◽  
Hospital Length Of Stay ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

Background: Extubation failure (ExtF) is associated with prolonged hospital length of stay and mortality in adult cardiac surgery patients postoperatively. In this population, ExtF-related variables such as the arterial partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2/FiO2), rapid shallow breathing index, cough strength, endotracheal secretions and neurological function have been sparsely researched. Aim: To identify variables that are predictive of ExtF and related outcomes. Method: Prospective observational longitudinal study. Consecutively presenting patients ( n=205) undergoing open-heart cardiac surgery and admitted to the Cardiosurgical Intensive Care Unit (CICU) were recruited. The clinical data were collected at CICU admission and immediately prior to extubation. ExtF was defined as the need to restart invasive or non-invasive mechanical ventilation while the patient was in the CICU. Results: The ExtF incidence was 13%. ExtF related significantly to hospital mortality, CICU length of stay and total hospital length of stay. The risk of ExtF decreased significantly, by 93% in patients with good neurological function and by 83% in those with a Rapid Shallow Breathing Index of ≥57 breaths/min per litre. Conversely, ExtF risk increased 27 times when the PaO2/FiO2 was <150 and 11 times when it was ≥450. Also, a reassuring PaO2/FiO2 value may hide critical pulmonary or extra-pulmonary conditions independent from alveolar function. Conclusion: The decision to extubate patients should be taken after thoroughly discussing and combining the data derived from nursing and medical clinical assessments. Extubation should be delayed until the patient achieves safe respiratory, oxygenation and haemodynamic conditions, and good neurocognitive function.

scholarly journals Success or failure predictive indexes of extubation in renal transplants patients under mechanical ventilation – pilot study

2020 ◽  
pp. 1-7
Author(s):  
Luciana Domingues Angelo da Silva ◽  
Marcella M. Musumeci F. Almeida ◽  
Matheus Oliveira Quaresma ◽  
Talita Castro ◽  
Mariana Ares Santos ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Oxygenation Index ◽  
Extubation Failure ◽  
Inspiratory Pressure ◽  
Major Health Problem ◽  
Maximum Inspiratory Pressure ◽  
Transplant Patients ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

Introduction: Currently, chronic kidney disease (CKD) is a major health problem and in the most severe conditions, kidney transplantation is an alternative treatment. However immunosuppression induced these patients to respiratory complications and endotracheal intubation. In order to assist the decision of the best time for weaning and extubation of these patients, there are predictive indexes that should be considered in preliminary assesment. Objective: To check the capacity of predictive indexes for weaning of mechanical ventilation, rapid shallow breathing index (RSBI), oxygenation rate (PaO2 /FiO2 ) and maximum inspiratory pressure (MIP) in predicting the success or extubation failure in kidney transplant patients. Methods: This study is a prospective cohort carried out with patients aged over 18, under mechanical ventilation for more than 24 hours. The patients were submitted to the Spontaneous Breathing Test, also the assessment of the Rapid Shallow Breathing Index, oxygenation index (PaO2 /FiO2 ), and maximum inspiratory pressure (MIP) and they were observed during 48 hours after to evaluate the success and extubation failure. Results: A total of 106 patients were eligible, and 20 of these were included with mean age of 46.9 ± 3.06 years and 14 of the subjects were male. Three patients showed extubation failure, and needed to have reintubation within the period of 48 hours as considered. Conclusion: The indices to predict weaning of mechanical ventilation, when within the expected normal values, seem to be able to predict extubation, with the exception of MIP that, even in cases of success, showed itself to be at levels lower than the predicted percentage.

scholarly journals Predictive value of rapid shallow breathing index in relation to the weaning outcome in ICU patients

2016 ◽  
Vol 65 (2) ◽  
pp. 465-472
Author(s):  
Hoda A. Abu Youssef ◽  
Alaa Eldin O. Shalaby ◽  
Ahmed M. Abd El Hafiz ◽  
Marwa M. Shaban ◽  
Hamed A.G. Hamed
Keyword(s):  
Predictive Value ◽  
Icu Patients ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Weaning Outcome ◽  
Rapid Shallow Breathing

Predictive value of diaphragmatic rapid shallow breathing index in mechanical ventilation weaning: a systematic review and meta-analysis

2020 ◽  
Keyword(s):  
Mechanical Ventilation ◽  
Predictive Value ◽  
Cochrane Library ◽  
Ultrasound Technique ◽  
Rapid Shallow Breathing Index ◽  
Weaning Failure ◽  
Ventilation Weaning ◽  
Shallow Breathing ◽  
Mechanical Ventilation Weaning ◽  
Rapid Shallow Breathing

Background: Mechanical ventilation weaning is a multifactorial process. D-RSBI cannot only reflect the respiratory function but also the diaphragmatic function with the bedside ultrasound technique. Objective: This review aimed to assess the predictive value of diaphragmatic rapid shallow breathing index (D-RSBI) of weaning outcome. Method: Databases were systematically reviewed including PubMed, Cochrane Library, Embase, CNKI and WanFang Data. Sensitivity and specificity were pooled with random effects models. Results: Nine studies met the inclusion criteria and 568 patients were involved. D-RSBI had a pooled sensitivity of 0.84 and a pooled specificity of 0.87 which predicted weaning success. D-RSBI in the success group was significantly lower than the weaning failure group. Conclusion: D-RSBI is a sensitive and specific predictor for weaning outcomes in spite of the limitations and heterogeneity among the studies. Further studies focusing on particular disease are needed as well.

scholarly journals Prognostic Value of Rapid Shallow Breathing Index for Weaning Success in Intensive Care Unit Patients under Mechanical Ventilation

2020 ◽  
Vol 6 (1) ◽  
pp. 9-14
Author(s):  
Md Sirajul Islam ◽  
Md Ali Haider ◽  
Uzzwal Kumar Mallick ◽  
Mohammad Asaduzzaman ◽  
Md Gias Uddin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Prolonged Mechanical Ventilation ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

Background: The weaning success in intensive care unit patients under mechanical ventilation is very important. Objective: The purpose of this study was to investigate the efficacy and effects of rapid shallow breathing index (RSBI) in predicting weaning success in patients with prolonged mechanical ventilation more than 48 hours. Methodology: This prospective cohort study was conducted in the Department of Anesthesia, Pain Palliative & Intensive Care Unit of Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2014 to December 2015 for a period of two (02) years. Patients on mechanical ventilation more than 48 hours with the age of 18 to 60 years were included in this study. During the weaning process, the arterial blood gases (ABG) values was checked and the patients was separated from mechanical ventilation. After measuring RSBI, patients was separated from mechanical ventilator and given T-piece trial (1 to 4 hours) and finally extubated as per advice of ICU consultant and observed for 48 hours. The patients were divided in two groups low RSBI ≤105 breath/min/L and high RSBI >105 breath/min/L. These patients were prospectively followed up to 48 hours in ICU and HDU. Result: A total of 117 patients were included in this study. The validity of RSBI evaluation for trail failure was correlated by calculating sensitivity, specificity, accuracy, positive and negative predictive values. The sensitivity of RSBI was 54.5% (95% CI 23.38% to 83.25%) and specificity was 82.1% (95% CI 73.43% to 88.85%). However, positive predictive value and negative predictive value were 24.0% (95% CI 13.84% to 38.30%) and 94.6% (95% CI 90.05% to 97.10%) respectively. The accuracy was found 79.5% (95% CI 71.03% to 86.39%). Receiver-operator characteristic (ROC) were constructed using RSBI of the weaning outcome, which gave a RSBI cut off value of ≥88 as the value with a best combination of sensitivity (72.7%) and specificity (61.3%), accuracy (60.7%), positive predictive value (15.7%), negative predictive value (95.5%) for trail failure. Conclusion: In conclusion the efficacy and effects of rapid shallow breathing index is found low sensitivity with high specificity in predicting weaning success in patients with prolonged mechanical ventilation more than 48 hours. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 9-14

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