Predictive Value of Serial Rapid Shallow Breathing Index Measurements for Extubation Success in Intensive Care Unit Patients

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 8; p. 1329
• Main Authors: Turhan, Semin, Tutan, Duygu, Şahiner, Yeliz, Kısa, Alperen, Özdemir, Sibel Önen, Tutan, Mehmet Berksun, Kayır, Selçuk, Doğan, Güvenç
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-08-2024; MDPI
• Subjects: Accuracy; Adult; Aged; Airway Extubation - methods; Airway Extubation - statistics & numerical data; Blood pressure; Consciousness; Extubation; extubation success; Female; Heart failure; Heart rate; Hemodynamics; Hospital patients; Humans; Intensive care; intensive care unit; Intensive Care Units; Intubation; Male; mechanical ventilation; Medical research; Medicine, Experimental; Middle Aged; Mortality; Neuromuscular diseases; Ostomy; Patients; Pneumonia; predictive value; Predictive Value of Tests; Prospective Studies; Respiration, Artificial - methods; ROC Curve; Sepsis; serial rapid shallow breathing index; Success; Ventilator Weaning - methods; Ventilators; Weaning; serial rapid shallow breathing index; intensive care unit; predictive value; extubation success; mechanical ventilation
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60081329

: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation.
: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups.
: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (
= 0.246,
= 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (
= 0.013,
= 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (
= 0.001). The ΔRSBI was higher in the unsuccessful group (
= 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ≤ 72 (AUC 0.715) and ΔRSBI ≤ -3 (AUC 0.648). RSBI-2a ≤ 72 increased the likelihood of successful extubation by 10.8 times, while ΔRSBI ≤ -3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times.
: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.