Rapid shallow breathing index

Manjush Karthika, Farhan A Al Enezi, Lalitha V Pillai, Yaseen M Arabi, Manjush Karthika, Farhan A Al Enezi, Lalitha V Pillai, Yaseen M Arabi

Abstract

Predicting successful liberation of patients from mechanical ventilation has been a focus of interest to clinicians practicing in intensive care. Various weaning indices have been investigated to identify an optimal weaning window. Among them, the rapid shallow breathing index (RSBI) has gained wide use due to its simple technique and avoidance of calculation of complex pulmonary mechanics. Since its first description, several modifications have been suggested, such as the serial measurements and the rate of change of RSBI, to further improve its predictive value. The objective of this paper is to review the utility of RSBI in predicting weaning success. In addition, the use of RSBI in specific patient populations and the reported modifications of RSBI technique that attempt to improve the utility of RSBI are also reviewed.

Keywords: Extubation; mechanical ventilation; rapid shallow breathing index; rapid shallow breathing index rate; reintubation; weaning.

References

    1. Manthous CA. Summarizing the logistics of liberation from mechanical ventilation. Respir Care Clin N Am. 2000;6:463–8. vi.
    1. Tobin M, Alex C. Discontinuation of mechanical ventilation. Principles and Practice of Mechanical Ventilation. New York: McGraw-Hill; 1994.
    1. MacIntyre NR. Evidence-based ventilator weaning and discontinuation. Respir Care. 2004;49:830–6.
    1. Frutos-Vivar F, Ferguson ND, Esteban A, Epstein SK, Arabi Y, Apezteguía C, et al. Risk factors for extubation failure in patients following a successful spontaneous breathing trial. Chest. 2006;130:1664–71.
    1. Tobin MJ. Advances in mechanical ventilation. N Engl J Med. 2001;344:1986–96.
    1. Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med. 2008;358:1327–35.
    1. Kollef MH, Silver P, Murphy DM, Trovillion E. The effect of late-onset ventilator-associated pneumonia in determining patient mortality. Chest. 1995;108:1655–62.
    1. Lloyd GG. Psychological problems and the intensive care unit. BMJ. 1993;307:458–9.
    1. Pochard F, Lanore JJ, Bellivier F, Ferrand I, Mira JP, Belghith M, et al. Subjective psychological status of severely ill patients discharged from mechanical ventilation. Clin Intensive Care. 1995;6:57–61.
    1. Esteban A, Alía I, Ibañez J, Benito S, Tobin MJ. Modes of mechanical ventilation and weaning. A national survey of Spanish hospitals. The Spanish Lung Failure Collaborative Group. Chest. 1994;106:1188–93.
    1. Eskandar N, Apostolakos MJ. Weaning from mechanical ventilation. Crit Care Clin. 2007;23:263–74. x.
    1. Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med. 1991;324:1445–50.
    1. Epstein SK. Etiology of extubation failure and the predictive value of the rapid shallow breathing index. Am J Respir Crit Care Med. 1995;152:545–9.
    1. Jacob B, Chatila W, Manthous CA. The unassisted respiratory rate/tidal volume ratio accurately predicts weaning outcome in postoperative patients. Crit Care Med. 1997;25:253–7.
    1. Thiagarajan RR, Bratton SL, Martin LD, Brogan TV, Taylor D. Predictors of successful extubation in children. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1562–6.
    1. Lessa FA, Paes CD, Tonella RM, Araújo S. Comparison of the rapid shallow breathing index (RSBI) calculated under direct and indirect form on the postoperative period of cardiac surgery. Rev Bras Fisioter. 2010;14:503–9.
    1. Soo Hoo GW, Park L. Variations in the measurement of weaning parameters: A survey of respiratory therapists. Chest. 2002;121:1947–55.
    1. Shingala H, Abouzgheib W, Darrouj J, Pratter M. Comparison of rapid shallow breathing index measured on pressure support ventilation and spontaneous breathing trial to predict weaning from mechanical ventilation. Chest. 2009;136:32S.
    1. El-Khatib MF, Zeineldine SM, Jamaleddine GW. Effect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients. Intensive Care Med. 2008;34:505–10.
    1. Patel KN, Ganatra KD, Bates JH, Young MP. Variation in the rapid shallow breathing index associated with common measurement techniques and conditions. Respir Care. 2009;54:1462–6.
    1. El-Khatib MF, Jamaleddine GW, Khoury AR, Obeid MY. Effect of continuous positive airway pressure on the rapid shallow breathing index in patients following cardiac surgery. Chest. 2002;121:475–9.
    1. Zhang B, Qin YZ. Comparison of pressure support ventilation and T-piece in determining rapid shallow breathing index in spontaneous breathing trials. Am J Med Sci. 2014;348:300–5.
    1. Seymour CW, Cross BJ, Cooke CR, Gallop RL, Fuchs BD. Physiologic impact of closed-system endotracheal suctioning in spontaneously breathing patients receiving mechanical ventilation. Respir Care. 2009;54:367–74.
    1. Epstein SK, Ciubotaru RL. Influence of gender and endotracheal tube size on preextubation breathing pattern. Am J Respir Crit Care Med. 1996;154(6 Pt 1):1647–52.
    1. Krieger BP, Isber J, Breitenbucher A, Throop G, Ershowsky P. Serial measurements of the rapid-shallow-breathing index as a predictor of weaning outcome in elderly medical patients. Chest. 1997;112:1029–34.
    1. Tanios MA, Nevins ML, Hendra KP, Cardinal P, Allan JE, Naumova EN, et al. A randomized, controlled trial of the role of weaning predictors in clinical decision making. Crit Care Med. 2006;34:2530–5.
    1. Danaga AR, Gut AL, Antunes LC, Ferreira AL, Yamaguti FA, Christovan JC, et al. Evaluation of the diagnostic performance and cut-off value for the rapid shallow breathing index in predicting extubation failure. J Bras Pneumol. 2009;35:541–7.
    1. Boutou AK, Abatzidou F, Tryfon S, Nakou C, Pitsiou G, Argyropoulou P, et al. Diagnostic accuracy of the rapid shallow breathing index to predict a successful spontaneous breathing trial outcome in mechanically ventilated patients with chronic obstructive pulmonary disease. Heart Lung. 2011;40:105–10.
    1. Purro A, Appendini L, De Gaetano A, Gudjonsdottir M, Donner CF, Rossi A. Physiologic determinants of ventilator dependence in long-term mechanically ventilated patients. Am J Respir Crit Care Med. 2000;161(4 Pt 1):1115–23.
    1. Oribabor CE, Mansuroglu N, Khusid F, Patten A, Suleiman M, Primiano J, et al. Low extubation times in cardiac surgery patients using the rapid shallow breathing index. Chest. 2005;128:273S.
    1. Pinsky MR. Cardiovascular issues in respiratory care. Chest. 2005;128(5 Suppl 2):592S–7S.
    1. Siegel MD. Technique and the rapid shallow breathing index. Respir Care. 2009;54:1449–50.
    1. Vidotto MC, Sogame LC, Calciolari CC, Nascimento OA, Jardim JR. The prediction of extubation success of postoperative neurosurgical patients using frequency-tidal volume ratios. Neurocrit Care. 2008;9:83–9.
    1. dos Reis HF, Almeida ML, da Silva MF, Moreira JO, Rocha Mde S. Association between the rapid shallow breathing index and extubation success in patients with traumatic brain injury. Rev Bras Ter Intensiva. 2013;25:212–7.
    1. Chao DC, Scheinhorn DJ. Determining the best threshold of rapid shallow breathing index in a therapist-implemented patient-specific weaning protocol. Respir Care. 2007;52:159–65.
    1. Newth CJ, Venkataraman S, Willson DF, Meert KL, Harrison R, Dean JM, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10:1–11.
    1. Farias JA, Alía I, Retta A, Olazarri F, Fernández A, Esteban A, et al. An evaluation of extubation failure predictors in mechanically ventilated infants and children. Intensive Care Med. 2002;28:752–7.
    1. Venkataraman ST, Khan N, Brown A. Validation of predictors of extubation success and failure in mechanically ventilated infants and children. Crit Care Med. 2000;28:2991–6.
    1. Mhanna MJ, Anderson IM, Iyer NP, Baumann A. The use of extubation readiness parameters: A survey of pediatric critical care physicians. Respir Care. 2014;59:334–9.
    1. Smailes ST, McVicar AJ, Martin R. Cough strength, secretions and extubation outcome in burn patients who have passed a spontaneous breathing trial. Burns. 2013;39:236–42.
    1. Verceles AC, Diaz-Abad M, Geiger-Brown J, Scharf SM. Testing the prognostic value of the rapid shallow breathing index in predicting successful weaning in patients requiring prolonged mechanical ventilation. Heart Lung. 2012;41:546–52.
    1. Berg KM, Lang GR, Salciccioli JD, Bak E, Cocchi MN, Gautam S, et al. The rapid shallow breathing index as a predictor of failure of noninvasive ventilation for patients with acute respiratory failure. Respir Care. 2012;57:1548–54.
    1. Soleimanpour H, Taghizadieh A, Salimi R, Golzari SE, Mahmoodpoor A, Safari S, et al. Rapid shallow breathing index survey, a predictor of non-invasive ventilation necessity in patients with chronic obstructive pulmonary disease exacerbation: An analytical descriptive prospective study. Iran Red Crescent Med J. 2014;16:e13326.
    1. Tobin MJ, Yang K. Weaning from mechanical ventilation. Crit Care Clin. 1990;6:725–47.
    1. Chatila W, Jacob B, Guaglionone D, Manthous CA. The unassisted respiratory rate-tidal volume ratio accurately predicts weaning outcome. Am J Med. 1996;101:61–7.
    1. Kuo PH, Wu HD, Lu BY, Chen MT, Kuo SH, Yang PC. Predictive value of rapid shallow breathing index measured at initiation and termination of a 2-hour spontaneous breathing trial for weaning outcome in ICU patients. J Formos Med Assoc. 2006;105:390–8.
    1. Teixeira C, Zimermann Teixeira PJ, Hohër JA, de Leon PP, Brodt SF, da Siva Moreira J. Serial measurements of f/VT can predict extubation failure in patients with f/VT < or = 105? J Crit Care. 2008;23:572–6.
    1. Shah N, Lee B, Colice G. Analysis of rapid shallow breathing index as a predictor for successful extubation from mechanical ventilation. Chest. 2004;126:756–7.
    1. Segal LN, Oei E, Oppenheimer BW, Goldring RM, Bustami RT, Ruggiero S, et al. Evolution of pattern of breathing during a spontaneous breathing trial predicts successful extubation. Intensive Care Med. 2010;36:487–95.

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