Value of the PaO₂:FiO₂ ratio and Rapid Shallow Breathing Index in predicting successful extubation in hypoxemic respiratory failure.
OBJECTIVE
We sought to determine the predictive value of the PaO₂:FiO₂ ratio (PFR), both independently and in combination with the standard Rapid Shallow Breathing Index (RSBI), for successful extubations in patients with primary hypoxemic respiratory failure (HRF).


METHODS
A retrospective chart review of 154 patients with HRF requiring mechanical ventilation for ≥24 hours was performed. The primary outcome was reintubation within 48 hours.


RESULTS
142 (92%) patients were successfully extubated. Pre-extubation PFR and RSBI values among reintubated and successfully extubated patients were similar. The areas under the curve of the receiver operating characteristic curves using RSBI and PFR were .5 and .62, respectively. A PFR < 200 or RSBI ≥ 70 when the PFR was ≥200 indicated a higher risk of reintubation, with .7 sensitivity and .56 specificity (area under the curve, .69), using a classification and regression tree model.


CONCLUSIONS
Neither the PFR independently nor the PFR in combination with the RSBI in a classification and regression tree model accurately predicted successful extubation in patients with HRF.
El Khoury
Marc Y
MY
Division of Infectious Diseases, New York Medical College, Valhalla, New York 10595, USA. drmarckhoury@gmail.com
Panos
Ralph J
RJ
Ying
Jun
J
Almoosa
Khalid F
KF
D019540:Area Under Curve; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000473:pathology; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010092:Oximetry; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods*