Clinical utility of rapid shallow breathing index in predicting successful weaning: secondary analysis of the COBRE-US trial

IF 2.7 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva Pub Date : 2025-02-01 DOI:10.1016/j.medin.2024.05.018

Fabio Varón-Vega , Eduardo Tuta-Quintero , Henry Robayo-Amortegui , Adriana Rincón , Luis F. Giraldo-Cadavid , Jonathan Palacios , Stephanie Crevoisier , Diana C. Duarte , Marcela Poveda , Laura Cucunubo , Pablo Monedero

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引用次数: 0

Abstract

Objective

To assess the predictive capacity of the Rapid Shallow Breathing Index (RSBI) for success in spontaneous breathing trials (SBT) and extubation in critically ill patients. We evaluated the association between RSBI, duration of mechanical ventilation, and ventilator-free time at 28 days.

Design

Prospective multicenter observational study. Secondary analysis of the COBRE-US study.

Setting

Intensive care unit (ICU).

Patients or participants

367 patients in the ICU receiving invasive mechanical ventilation.

Interventions

Assessment of RSBI at the end of SBT.

Main variables of interest

RSBI, SBT, duration of mechanical ventilation, and ventilator-free time at 28 days were evaluated.

Results

367 patients in the ICU under invasive mechanical ventilation were evaluated, of whom 59.7% were male with a median age of 61 years (IQR: 49–72). A total of 456 SBT were conducted with a success rate of 76.5%. RSBI had a ROC-curve of 0.53 for SBT success and a ROC-curve of 0.48 for extubation. The Spearman correlation coefficient between RSBI and duration of ventilation was 0.117 (p = 0.026), while for ventilator-free time at 28 days, it was −0.116 (p = 0.028).

Conclusions

RSBI was not associated with success in SBT or extubation, regardless of the cutoff point used. Correlation analyses showed weak associations between RSBI and both the duration of ventilation and ventilator-free time at 28 days.

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快速浅呼吸指数在预测成功脱机中的临床应用：COBRE-US试验的二次分析

目的评价快速浅呼吸指数（RSBI）对危重患者自主呼吸试验（SBT）及拔管成功的预测能力。我们评估了RSBI、机械通气持续时间和28天无呼吸机时间之间的关系。前瞻性多中心观察性研究。COBRE-US研究的二次分析。重症监护病房（ICU）。患者或参与者：ICU中接受有创机械通气的患者367例。SBT结束时RSBI的干预评估。评估主要变量sbi、SBT、机械通气持续时间和28 d无呼吸机时间。结果ICU有创机械通气患者367例，男性占59.7%，中位年龄61岁（IQR: 49 ~ 72）。共进行了456次SBT，成功率为76.5%。SBT成功的RSBI roc曲线为0.53，拔管的roc曲线为0.48。RSBI与通气时间的Spearman相关系数为0.117 (p = 0.026)，与28 d无呼吸机时间的Spearman相关系数为- 0.116 （p = 0.028）。结论无论使用何种截止点，srsbi与SBT或拔管成功无关。相关分析显示，RSBI与通气持续时间和28天无呼吸机时间之间存在弱相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medicina Intensiva CRITICAL CARE MEDICINE-

CiteScore

2.70

自引率

20.00%

发文量

146

审稿时长

33 days

期刊介绍： Medicina Intensiva is the journal of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) and of Pan American and Iberian Federation of Societies of Intensive and Critical Care Medicine. Medicina Intensiva has become the reference publication in Spanish in its field. The journal mainly publishes Original Articles, Reviews, Clinical Notes, Consensus Documents, Images, and other information relevant to the specialty. All works go through a rigorous selection process. The journal accepts submissions of articles in English and in Spanish languages. The journal follows the publication requirements of the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).