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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.

TitleDiagnostic accuracy of the rapid shallow breathing index to predict a successful spontaneous breathing trial outcome in mechanically ventilated patients with chronic obstructive pulmonary disease.
Publication TypeJournal Article
Year of Publication2011
AuthorsBoutou, A. K., Abatzidou F., Tryfon S., Nakou C., Pitsiou G., Argyropoulou P., & Stanopoulos I.
JournalHeart Lung
Volume40
Issue2
Pagination105-10
Date Published2011 Mar-Apr
ISSN1527-3288
KeywordsAged, APACHE, Female, Glasgow Coma Scale, Health Status Indicators, Humans, Male, Oxygen Consumption, Predictive Value of Tests, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Respiration, Respiration, Artificial, Respiratory Function Tests, Sensitivity and Specificity, Statistics, Nonparametric, Time Factors, Treatment Outcome
Abstract

OBJECTIVE: To evaluate the diagnostic accuracy of 2 threshold values (105 breaths per minute [bpm]/L and 130 bpm/L) of the rapid shallow breathing index (RSBI) to predict a successful weaning trial outcome in a homogenous group of patients with chronic obstructive pulmonary disease (COPD).METHODS: A consecutive population of patients with COPD who were intubated for hypercapnic respiratory failure during a 2-year period were studied prospectively. RSBI was measured by 2 investigators at minute 5 of the T-piece trial, whereas 2 other physicians evaluated the 30 minute T-piece trial as successful or unsuccessful, according to clinical criteria.RESULTS: Of 64 patients with COPD (53 male, 11 female) who constituted the study population, 42 patients (35 male, 7 female; aged 70 ± 9.2 years) completed the spontaneous breathing trial (SBT) and remained clinically stable (group 1). The remaining 22 patients (18 male, 4 female; aged 71.9 ± 4.7 years) had to return to ventilatory support by the end of the SBT because of clinical deterioration (group 2). The 2 threshold values that were evaluated had low specificity (38.1% for < 105 bpm/L and 66.7% for < 130 bpm/L), low sensitivity (63.6% for < 105 bpm/L and 54.5% for < 130 bpm/L), and low diagnostic accuracy (46.8% for < 105 bpm/L and 65.6% for < 130 bpm/L) in predicting a successful T-piece trial outcome.CONCLUSION: RSBI measured early during an SBT cannot accurately predict the successful outcome of a T-piece trial in a homogenous population of patients with COPD.

DOI10.1016/j.hrtlng.2010.02.002
Alternate JournalHeart Lung
PubMed ID20561873

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