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. 2015 Dec;27(12):3723-7.
doi: 10.1589/jpts.27.3723. Epub 2015 Dec 28.

Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning

Umilson Dos Santos Bien  1 , Gerson Fonseca Souza  2 , Elisangela Siqueira Campos  3 , Etiene Farah de Carvalho  1 , Matheus Guedes Fernandes  1 , Ilka Santoro  3 , Dirceu Costa  1 , Ross Arena  4 , Luciana Maria Malosá Sampaio  1
Affiliations

Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning

Umilson Dos Santos Bien et al. J Phys Ther Sci. 2015 Dec.

Abstract

[Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ≥15 years who underwent orotracheal intubation for mechanical ventilation and who met the criteria of the weaning protocol were included in the study. Receiver operating characteristic (ROC) curves were calculated for the analysis of each index. [Results] Logistic regression analysis was also performed. MIP showed greater sensitivity and specificity [area under the curve (AUC): 0.95 vs. 0.89] and likelihood ratios (LR) (positive(+): 20.85 vs. 9.45; negative(-): 0.07 vs. 0.17) than RSBI in the overall sample (OS) as well as in clinical patients (CP) (AUC: 0.99 vs. 0.90; LR+: 24.66 vs. 7.22; LR-: 0.01 vs. 0.15) and surgical patients (SP) (AUC: 0.99 vs. 0.87; LR+: 9.33 vs. 5.86; LR-: 0.07 vs. 0.14). The logistic regression analysis revealed that both parameters were significantly associated with the weaning success. The MIP showed greater accuracy than the RSBI (OS: 0.93 vs. 0.85; CP: 0.98 vs. 0.87; SP: 0.93 vs. 0.87). [Conclusion] Both parameters are good predictors of successful ventilator weaning.

Keywords: Mechanical ventilation; Physiological predictor indices; Ventilator weaning.

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Figures

Fig. 1
Fig. 1
. Weaning protocol FiO2: fraction of inspired oxygen; PEEP: positive end-expiratory pressure; PaO2/FiO2: ratio of arterial oxygen and fraction of inspired oxygen, pH: potential of hydrogen; Glasgow: coma scale; SBP: systolic blood pressure, HR: heart rate, Tax: axillary temperature; MIP: maximal inspiratory pressure, SP: pressure support, Rf: respiratory rate, TV: tidal volume, IRRS: index of rapid shallow breathing; T Tube: peace for oxygen therapy
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References

    1. Hess DR, MacIntyre NR: Ventilator discontinuation: why are we still weaning? Am J Respir Crit Care Med, 2011, 184: 392–394. - PubMed
    1. Macintyre NR: Evidence-based assessments in the ventilator discontinuation process. Respir Care, 2012, 57: 1611–1618. - PubMed
    1. Frutos-Vivar F, Ferguson ND, Esteban A, et al. : Risk factors for extubation failure in patients following a successful spontaneous breathing trial. Chest, 2006, 130: 1664–1671. - PubMed
    1. Tobin MJ, Jubran A: Variable performance of weaning-predictor tests: role of Bayes’ theorem and spectrum and test-referral bias. Intensive Care Med, 2006, 32: 2002–2012. - PubMed
    1. Frutos-Vivar F, Esteban A: Weaning from mechanical ventilation: why are we still looking for alternative methods? Med Intensiva, 2013, 37: 605–617. - PubMed

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