title: Preliminary evaluation of a new index to predict the outcome of a spontaneous breathing trial.
abstract: BACKGROUND
  The available predictors of spontaneous-breathing-trial (SBT) success/failure lack accuracy. We devised a new index, the CORE index (compliance, oxygenation, respiration, and effort).
  
  
  OBJECTIVE
  To compare the CORE index to the CROP index (compliance, rate, oxygenation,  and pressure), airway-occlusion pressure 0.1 s after the start of inspiratory flow (P(0.1)), and rapid shallow breathing index (RSBI) for predicting SBT success/failure in a critical care environment.
  
  
  METHODS
  With 47 mechanically ventilated patients recovering from respiratory failure,  of various causes, we prospectively examined the SBT success/failure prediction accuracy and calculated receiver operating characteristic curves, sensitivity, specificity, and likelihood ratios of CORE, CROP, P(0.1), and RSBI.
  
  
  RESULTS
  The specificities were CORE 0.95, P(0.1)  0.70, CROP 0.70, and RSBI 0.65. The sensitivities were CORE 1.00, CROP 1.00, P(0.1) 0.93, and RSBI 0.89. The areas under the receiver operating characteristic curve were CORE 1.00 (95% CI 0.92-1.00), CROP 0.91 (95% CI 0.79-0.97), P(0.1) 0.81 (95% CI 0.67-0.91),  and RSBI 0.77 (95% CI 0.62-0.88). The positive likelihood ratios were CORE 20.0, CROP 3.3, P(0.1) 3.1, and RSBI 2.5. The negative likelihood ratios were CORE 0.0, CROP 0.0, P(0.1) 0.1, and RSBI 0.2.
  
  
  CONCLUSIONS
  The CORE index was the most accurate predictor of SBT  success/failure.
authors.affiliation: Respiratory Therapy Department, Hôpital du Sacré-Coeur, Montréal, Québec, Canada. sdelisle@hotmail.com
authors.forename: Stéphane
authors.initials: S
authors.lastname: Delisle
authors.forename: Martin
authors.initials: M
authors.lastname: Francoeur
authors.forename: Martin
authors.initials: M
authors.lastname: Albert
authors.forename: Paul
authors.initials: P
authors.lastname: Ouellet
authors.forename: Patrick
authors.initials: P
authors.lastname: Bellemare
authors.forename: Pierre
authors.initials: P
authors.lastname: Arsenault
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy; D012372:ROC Curve; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics; D015300:Ventilator Weaning