To Assess Rapid Shallow Breathing Index as a Predictor for Weaning in Intensive Care Unit Patients
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 6
Abstract
Background: Weaning from mechanical ventilation (MV) is a major concern for the intensivist and has disastrous results when not accomplished as per the protocols. The preweaning assessment of the patient, address of the underlying condition for which the ventilation was initiated, for recognition of difficult to wean in advance is the best method of preventing damage caused by the inability to maintain the airway. Aim: This study was carried out to evaluate the efficacy of clinical test rapid shallow breathing index (RSBI) which can predict the successful weaning in patients undergoing elective or mandatory MV. Materials and Methods: A total of 120 adult patients of age group 18–70 years of either sex of ASA Class I and II, undergoing MV for various procedures, were included in this study. Preweaning evaluation is carried out by measuring demographic variables, hemodynamic variables, arterial blood gas (ABG), and calculation of RSBI. These variables were then correlated with the success of weaning, successful extubation, need for reintubation, requirement of non-invasive support, and validation of pre-existing RSBI values. Data are presented as the mean ± standard deviation. Results having P < 0.05 were considered statistically significant. Results: Sensitivity, specificity, positive predictive value, and negative predictive value of RSBI <105 as an index for successful weaning were 86.4%, 69.85%, 56.1, and 92.1, respectively. No method either individually or in combination with other identifies all cases of successful weaning. Overall failure to wean rate was 30.43% which was comparable with most of the other studies. There was a weak positive correlation between age and weaning failure, but it was not statistically significant. Correlation between weight and weaning failure was not established. There was a weak negative correlation between the duration of intubation and weaning failure. Patients who were intubated for longer period of time were associated with more incidence of weaning failure, but it was not statistically significant. The higher PaO2/FiO2 ratio was associated with successful weaning, and there was a statistical significant difference among both groups. Bipap support was required in 15.8% patients in 48 h.
Authors and Affiliations
Deepti Agarwal, Veena Kachhwah, Krishna Kumar Thakur, Neeraj Narang
Keywords
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