Effect of Using the Rapid Shallow Breathing Index as Readiness Criterion for Spontaneous Breathing Trials in a Weaning Protocol
| Autor: | Angelica Lehker, Jose Garcia-Blanco, Ricardo Montoya, Antonyos Mahfoud, Juan B. Figueroa-Casas, Ahmed M. Hussein, Haider Abdulmunim, Giselle Kabbach |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Mechanical ventilation Ventilator weaning business.industry medicine.medical_treatment General Medicine Middle Aged 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Anesthesia Rapid shallow breathing index Respiratory Mechanics medicine Breathing Humans Weaning Female 030212 general & internal medicine business Ventilator Weaning Aged |
| Zdroj: | The American Journal of the Medical Sciences. 359:117-122 |
| ISSN: | 0002-9629 |
| DOI: | 10.1016/j.amjms.2019.11.002 |
| Popis: | Background This study aimed to compare the effect of using versus not using the Rapid-Shallow Breathing Index (RSBI) as a readiness criterion for Spontaneous Breathing Trials (SBT) on SBT success. Materials and Methods Daily readiness screens were performed within a respiratory therapist-driven weaning protocol. Patients who passed these screens underwent a one-time measurement of the RSBI and then a SBT regardless of RSBI result. The proportion of passed readiness screens reaching SBT success was compared to the proportion that would have been obtained if RSBI ≤ 105 br/min/L had been used as an additional screen criterion. Results Two hundred and fifty SBTs performed on 157 patients were analyzed. The sensitivity of RSBI ≤ 105 br/min/L to predict SBT success was 94.8% (95% CI 90.6-97.5). Relative to potentially using RSBI, 14.4% additional SBTs were performed. A third of these were successful, and no complications were detected in the rest that failed. The proportion of passed readiness screens reaching SBT success would have been 4% (95% CI 1.2-6.8) (P = 0.002) lower if RSBI had been used. Conclusions The inclusion of the RSBI in a readiness screen may not be useful in a weaning protocol. |
| Databáze: | OpenAIRE |
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