The Validation of Rapid Shallow Breathing Index on Weaning Off Mechanical Ventilator of Medical and Surgical Patients in Adult Intensive Care Unit

Background:

Medical professionals have set Rapid Shallow Breathing Index (RSBI) to predict whether or not patients can successfully wean from mechanical ventilator (MV). RSBI is measured with handheld spirometer or through MV. Measuring through MV has been proven to have less artificial error. Some studies have discussed the validation of RBSI of medical patients in Intensive Care Unit. Therefore, we want to compare the successful prediction rate of RSBI between medical patients and surgical patients.

Methods:

This is a retrospective study. We reviewed patients who were intubated and admitted to the adult Intensive Care Unit from June 2017 to December 2017. Patients' age, sex, height, weight, BMI, APACHE II within the first 24 h of hospitalization, and duration of MV use were collected. Excision criteria including: the patient's endotracheal tube ID was < 7.0 mm, or instances where the PEEP of the MV was set exceed 8 cm H₂O while measuring RSBI. Failing the weaning process is defined as they were re-intubated within five days or use noninvasive ventilator exceed 6 hours after extubation. The criteria of weaning successful is set up as RSBI < 105 (breaths/min/L). RSBI was measured through MV. Statistical analysis of the study was accomplished through the independent sample t-test and stratified Cox regression by using SPSS statistics 17.0.

Results:

A total 108 patients (medical: 62, surgical: 46) were enrolled for this study. Comparing medical patients with surgical patients, their sex (P=0.324), age (P=0.092), height (P=0.472), weight (P=0.879), BMI (P=0.893), APACHE II (P=0.721), duration of MV use (P=0.803) were found no significant difference. Their RSBI (P=0.007) and successful prediction rate (medical: 67. 7%, surgical: 87. 7%, total: 75%, P=0) were found significant difference. The result of weaning off MV among the enrolled patients, 81 patients were successfully predicted and 27 patients were not. Comparing successful group and unsuccessful group (Table. 1), only department was found a significant difference (P=0.033).

Conclusions:

In an adult intensive care unit, successful prediction rate of RSBI is high. And successful prediction rate of RSBI in surgical patients is even greater. The result was not affected by age, sex, height, weight, BMI, illness severity, and duration of MV use.

Result of prediction analysis

Table.1

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