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

Abstract

ObjectiveThe 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. MethodsA 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 ≤ 105; rate of change; and variability were assessed. ResultsTwenty-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 ± 14.2 vs 99.3 ± 30.2, P = .007; 71.7 ± 31.2 vs 123.3 ± 92.5, P = .005, respectively). RSBI variability and rate of change were different between groups (coefficient of variation, .37 ± .12 vs .51 ± .30, P = .02, rate of change: −3.40 ± 9.40 vs 4.40 ± 11.1 RSBI points/day, P = .005, weaned vs failed). ConclusionAlthough isolated RSBI measurements do not predict successful weaning from PMV, RSBI trends may have prognostic value.