Assessment of Rapid Shallow Breathing Index as a Predictor for Weaning in Respiratory Care Unit


Pulmonology Department, Labbafi Nejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: At present, air way support plays pivotal role in management of
patients in the ICU (Intensive Care Unit) and also RCU (Respiratory Care Unit).
Ventilator weaning is an important step in the care of ICU and RCU patients. It
is the gradual removal of mechanical ventilatory support. Different predictors
are used for initiation of weaning. This study was designed to investigate the
rapid shallow breathing index (RSBI) as a predictor for successful weaning.
Materials and Methods: This cross-sectional study was conducted on 70
patients who had mechanical ventilation for more than 48 hours in a respiratory
care unit in Tehran Labbafi Nejad Hospital. They were clinically stable and had
the criteria for weaning from the ventilator. We measured RSBI, and then
evaluated the value of RSBI for successful extubation. RSBI was calculated
when patients were on spontaneous breathing mode with PSV=0 and PEEP=0
for one minute.
Results: A total of 70 patients were included in this study; 63(90%) patients had
RSBI ≤105 (breath/min/L), among them 49 (77%) patients had successful
weaning and did not need re-intubation while the remaining had unsuccessful
weaning (P=0.001). The mean weaning index for patients with successful
extubation was 66 ± 57.2 and 76.9 ± 28.1 for patients with unsuccessful
extubaion. We could not find a significant difference between the means
Conclusion: Although RSBI RSBI alone may mislead the physicians. General status of the patient,
concomitant diseases and duration of hospital stay should all be considered for
successful weaning