Evaluation of the diagnostic performance and cut-off value for the rapid shallow breathing index in predicting extubation failure

Autor: Aline Roberta Danaga, Fábio Akio Yamaguti, José Carlos Christovan, Ubirajara Teixeira, Letícia Cláudia de Oliveira Antunes, Ana Beatriz Sasseron, Ana Lúcia Gut, Cristina Aparecida Veloso Guedes, Ana Lúcia dos Anjos Ferreira, Luis Cuadrado Martin
Přispěvatelé: Universidade Estadual Paulista (Unesp), Centro Universitário Hermínio Ometto - UNIARARAS
Jazyk: portugalština
Rok vydání: 2009
Předmět:
Zdroj: Jornal Brasileiro de Pneumologia v.35 n.6 2009
Jornal Brasileiro de Pneumologia
Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)
instacron:SBPT
SciELO
Repositório Institucional da UNESP
Universidade Estadual Paulista (UNESP)
instacron:UNESP
ISSN: 1806-3713
Popis: Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:43:56Z No. of bitstreams: 1 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) Made available in DSpace on 2013-08-22T18:43:56Z (GMT). No. of bitstreams: 1 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2013-09-30T18:17:53Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:43Z No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2014-05-20T13:33:43Z (GMT). No. of bitstreams: 2 S1806-37132009000600007.pdf: 187980 bytes, checksum: 4d2848fc455fc13f2d9eda4c5a87c475 (MD5) S1806-37132009000600007.pdf.txt: 30690 bytes, checksum: efb8d300c0c06c02594d918b045abdba (MD5) Previous issue date: 2009-06-01 OBJETIVO: Avaliar o desempenho diagnóstico do índice de respiração rápida e superficial (IRRS) na predição do insucesso da extubação de pacientes adultos em terapia intensiva e verificar a adequação do valor de corte clássico para esse índice. MÉTODOS: Estudo prospectivo realizado na unidade de terapia intensiva de adultos do Hospital das Clínicas da Faculdade de Medicina de Botucatu, através da avaliação do IRRS em 73 pacientes consecutivos considerados clinicamente prontos para extubação. RESULTADOS: O IRRS com valor de corte clássico (105 ciclos/min/L) apresentou sensibilidade de 20% e especificidade de 95% (soma = 115%). A análise da curva receiver operator characteristic (ROC) demonstrou melhor valor de corte (76,5 ciclos/min/L), o qual forneceu sensibilidade de 66% e especificidade de 74% (soma = 140%), e a área sob a curva ROC para o IRRS foi de 0,78. CONCLUSÕES: O valor de corte clássico do IRRS se mostrou inadequado nesta casuística, prevendo apenas 20% dos pacientes com falha na extubação. A obtenção do novo valor de corte permitiu um acréscimo substancial de sensibilidade, com aceitável redução da especificidade. O valor da área sob a curva ROC indicou satisfatório poder discriminativo do índice, justificando a validação de sua aplicação. OBJECTIVE: To evaluate the diagnostic performance of the rapid shallow breathing index (RSBI) in predicting extubation failure among adult patients in the intensive care unit and to determine the appropriateness of the classical RSBI cut-off value. METHODS: This was a prospective study conducted in the adult intensive care unit of the Botucatu School of Medicine Hospital das Clínicas. The RSBI was evaluated in 73 consecutive patients considered clinically ready for extubation. RESULTS: The classical RSBI cut-off value (105 breaths/min/L) presented a sensitivity of 20% and a specificity of 95% (sum = 115%). Analysis of the receiver operator characteristic (ROC) curve revealed a better cut-off value (76.5 breaths/min/L), which presented a sensitivity of 66% and a specificity of 74% (sum = 140%). The area under the ROC curve for the RSBI was 0.78. CONCLUSIONS: The classical RSBI cut-off value proved inappropriate, predicting only 20% of the cases of extubation failure in our sample. The new cut-off value provided substantial improvement in sensitivity, with an acceptable loss of specificity. The area under the ROC curve indicated that the discriminative power of the RSBI is satisfactory, which justifies the validation of this index for use. Universidade Estadual Paulista Faculdade de Medicina de Botucatu Centro Universitário Hermínio Ometto - UNIARARAS Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Clínica Médica Universidade Estadual Paulista Faculdade de Medicina de Botucatu Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Clínica Médica
Databáze: OpenAIRE
Externí odkaz: