The Science Journal of the American Association for Respiratory Care

1995 OPEN FORUM Abstracts

MEASUREMENT OF THE DYNAMIC RAPID SHALLOW BREATHING INDEX

SW Munroe MS, RRT, JD Zibrak MD, KM Dushay MD, C O'Donnell, Sc .D., MPH, M Feldman BS, RRT, KG Kendrick BS, RRT, GF MacDonald MBA, RRT, P Burke MD. Departments of Respiratory Care, Pulmonary Medicine, and General Surgery, Deaconess Hospital, Harvard Medical School, Boston, MA.

INTRODUCTION: A static RSBI of and > 105 has been shown to be both a good positive and negative predictor of weaning outcome respectively. We hypothesized that the dynamic RSBI measured over the course of a weaning trial on a minimal level of inspiratory pressure support (IPS) is a reliable predictor of weaning outcome.

Methods: We studied 12 stable patients who were being considered for extubation. We measured standard ventilatory mechanics, the static and dynamic RSBI on a minimum level of IPS. Data was analyzed for significance using the Mann Whitney test.

Results: Of the 12 patients studied, 7 were extubated successfully and 5 patients failed extubation. Duration of weaning trials ranged from 1 to 14 hours (mean of 5.1 hours). All of the patients who were extubated successfully satisfied standard weaning criteria including a static RSBI of and an average dynamic RSBI of. Of the patients who failed extubation, all 5 patients were unable to satisfy standard weaning criteria and had a static RSBI of > 105. Of these 5 patients, 4 patients had an average dynamic RSBI of > 105, while 1 patient had an average dynamic RSBI of 67.5 but still failed extubation. The static RSBI predicted weaning outcome in all 12 patients (p=0.002). The dynamic RSBI predicted weaning outcome in 11 out of 12 patients (p=0.005). CONCLUSION: In this small sample of patients, the dynamic RSBI was a reliable predictor of weaning outcome but not as good as the static RSBI and standard weaning criteria.

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