Assessment of the Rapid Shallow Breathing Index as a Predictor of Weaning of Patients with Prolonged Mechanical Ventilation

Mahoori, Ali Reza; Nowruzinia, Shiva; Farasatkish, Rasoul; Mollasadeghi, Golam Ali; Kianfar, Amir Abbas; Toutounchi, Mohammad Zia

Assessment of the Rapid Shallow Breathing Index as a Predictor of Weaning of Patients with Prolonged Mechanical Ventilation

Authors

Ali Reza Mahoori ¹

Shiva Nowruzinia ¹

Rasoul Farasatkish ²

Golam Ali Mollasadeghi ²

Amir Abbas Kianfar ³

Mohammad Zia Toutounchi ⁴

¹ Department of Anesthesiology, Urmia University of Medical Sciences, Urmia-Iran

² Department of Cardiac Anesthesiology, Shahid Rajaei Cardiovascular Medical Center, Iran University of Medical Sciences and Health Services, Tehran-Iran,

³ Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz- Iran.

⁴ Department of Cardiac Anesthesiology, Shahid Rajaei Cardiovascular Medical Center, Iran University of Medical Sciences and Health Services, Tehran-Iran

Abstract

Background: About 8% of patients experience prolonged mechanical ventilation after cardiac surgery. Development of criteria for successful liberation of a patient from mechanical ventilation and extubation may be highly dependent on the clinical situation. Different criteria were used for ventilator weaning. We designed a clinical trial to determine the usefulness of rapid shallow breathing index (RSBI) as a predictor for successful weaning from mechanical ventilation. Materials and Methods: In a prospective observational study, 52 patients who had prolonged mechanical ventilation (> 72 h) after open cardiac surgery were studied. Patients had 60 – min spontaneous breathing trials and satisfied at least 5 weaning predictors and fulfilled the criteria for discontinuing mechanical ventilation. Traditional weaning criteria and RSBI were determined. According to the outcome assessment of weaning, patients were divided into failure or success groups. Results: The mean RSBI values were significantly different between the failure (103.5±21.9 breath/min/L) and success groups (80.4±15.3 breath/min/L, p=0.0001). There was no significant difference regarding the values of other prediction criteria between the two groups. Using RSBI

Keywords

Outcome assessment

Ventilator weaning

Cardiac surgery

Rapid shallow breathing index