Abstract
BackgroundRapid shallow breathing index (RSBI) is the most commonly used parameter for predicting weaning outcome. Measurement of RSBI by Wright spirometer (RSBIstandard) is the standard method in routine clinical practice. Data specific to the accuracy and reliability of the RSBI value displayed by the ventilator (RSBIvent) are scarce. Accordingly, this study aimed to evaluate the association between the average value of RSBIvent at different time points and RSBIstandard, and to assess the accuracy and reliability of these two RSBI measurement techniques.MethodsThis prospective cohort study included mechanically ventilated patients who were ready to wean. At the beginning of spontaneous breathing trial using the flow-by method, RSBI was measured by two different techniques at the same time, including: (1) Wright spirometer (breathing frequency/average tidal volume in 1 min) (RSBIstandard), and (2) the values displayed on the ventilator at 0, 15, 30, 45, and 60 s (RSBIvent).ResultsForty-seven patients were enrolled. The RSBIvent value was significantly higher than the RSBIstandard value for every comparison. According to Spearman’s correlation coefficient (r) and intraclass correlation coefficient (ICC), the average value of RSBI from 5 time points (0, 15, 30, 45, and 60 s) showed the best correlation with the standard technique (r = 0.76 [P < 0.001], and ICC = 0.79 [95% CI 0.61–0.88], respectively). Bland–Altman plot also showed the best agreement between RSBIstandard and the RSBIvent value averaged among 5 time points (mean difference − 17.1 breaths/min/L).ConclusionsWe found that the ventilator significantly overestimates the RSBI value compared to the standard technique by Wright spirometer. The average RSBIvent value among 5 time points (0, 15, 30, 45, and 60 s) was found to best correlate with RSBIstandard.
Highlights
Rapid shallow breathing index (RSBI) is the most commonly used parameter for predicting weaning outcome
The results of this study showed that the ventilator significantly overestimated the RSBI value compared to the standard technique of RSBI measurement by Wright spirometer
Confidence interval (CI) confidence interval, ICC intraclass correlation coefficient, r Spearman’s correlation coefficient, RSBIstandard rapid shallow breathing index measured by the Wright spirometer, RSBIvent rapid shallow breathing index displayed by the ventilator to loss of positive-end expiratory pressure (PEEP) effect and risk of contamination of the breathing tube and circuit
Summary
Rapid shallow breathing index (RSBI) is the most commonly used parameter for predicting weaning outcome. This study aimed to evaluate the association between the average value of R SBIvent at different time points and RSBIstandard, and to assess the accuracy and reliability of these two RSBI measurement techniques. Mechanical ventilation is a life-saving treatment in critically ill patients with acute respiratory failure; prolonged mechanical ventilation significantly increases healthcare utilization and cost, and is associated with poor outcomes [1, 2]. Assessment of readiness to wean is an important step before performing a spontaneous breathing trial (SBT), and patient readiness should be evaluated as soon as possible after the patient recovers from acute respiratory failure. A cut-off value greater than 105 breaths/min/L has been used to predict weaning trial failure [12]. RSBI measurement using a Wright spirometer is a gold standard method; it requires a special instrument that might not be available at the bedside
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
