Evolution of pattern of breathing during a spontaneous breathing trial predicts successful extubation.

Intensive Care Medicine
Leopoldo N SegalStanley B Fiel

Abstract

Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. Prospective observational study. Seventy-two subjects were extubated. At 24 h, 63/72 remained extubated (Extubation Success), and 9 were re-intubated (Extubation Failure). Respiratory rate (RR), tidal volume (VT) and RSBI were measured every 30 min during 2-h T-piece SBT. Change in respiratory parameters was assessed as percent change from baseline. Initial RSBI was similar in Extubation Success and Extubation Failure groups (77.0 +/- 4.8, 77.0 +/- 4.8, p = ns). Nevertheless, RSBI tended to remain unchanged or decreased in the Extubation Success group; in contrast RSBI tended to increase in the Extubation Failure group because of either increased RR and/or decreased VT (p < 0.001 for mean percent change RSBI over time), indicating worsening of the respiratory pattern. Quantitatively, only 7/63 subjects of the Extubation Success group demonstrated increased RSBI >or=20% at any time during the SBT. In contrast, in the Extubati...Continue Reading

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Citations

Aug 7, 2012·Current Infectious Disease Reports·C Arianne BuchanAndrew J E Seely
Nov 12, 2013·Revista Brasileira de terapia intensiva·Helena França Correia dos ReisMário de Seixas Rocha
Oct 1, 2011·Journal of Critical Care·Augusto SaviUNKNOWN Gaúcho Weaning Study Group
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Aug 2, 2019·Dimensions of Critical Care Nursing : DCCN·Mary M DeivertFlorence E Turrentine
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Aug 4, 2021·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Guillaume FossatThierry Boulain

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