title: Testing the prognostic value of the rapid shallow breathing index in predicting successful weaning in patients requiring prolonged mechanical ventilation.
abstract: OBJECTIVE
  The study objective was to assess the prognostic value of the rapid shallow breathing index (RSBI) in predicting successful weaning of patients from prolonged mechanical ventilation (PMV) in long-term acute care (LTAC) facilities. The RSBI predicts successful ventilator weaning in acutely ill patients. However, its value in PMV is unclear.
  
  
  METHODS
  A retrospective cohort study of patients receiving PMV in LTAC facilities was performed. RSBI was measured daily, with weaning per protocol. Initial, mean, and final RSBI; RSBI ≤ 105; rate of change; and variability were assessed.
  
  
  RESULTS
  Twenty-five of 52 patients were weaned from PMV. Only the mean RSBI and the RSBI on the last day of weaning predicted success (78.7 ± 14.2 vs 99.3 ± 30.2, P = .007; 71.7 ± 31.2 vs 123.3 ± 92.5, P = .005, respectively). RSBI variability and rate of change were different between groups (coefficient of variation, .37 ± .12 vs .51 ± .30, P = .02, rate of change: -3.40 ± 9.40 vs 4.40 ± 11.1 RSBI points/day, P = .005, weaned vs failed).
  
  
  CONCLUSIONS
  Although isolated RSBI measurements do not predict successful weaning from PMV, RSBI trends may have prognostic value.
authors: University of Maryland School of Medicine, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Baltimore, Maryland 21201, USA. Avercele@medicine.umaryland.edu
authors: Avelino C
authors: AC
authors: Verceles
authors: Montserrat
authors: M
authors: Diaz-Abad
authors: Jeanne
authors: J
authors: Geiger-Brown
authors: Steven M
authors: SM
authors: Scharf
mesh_terms: D001944:Breath Tests / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods*