Role of Diaphragmatic rapid shallow breathing index in prediction of weaning failure during spontaneous breathing trial compared to Rapid Shallow Breathing Index

Abstract

RSBI is the most commonly used index in patients undergoing spontaneous respiration for weaning and has been compared and reported with regard to the effect of diaphragm volume creation on the new D-RSBI index, where diaphragm displacement was used instead of the current volume. D-RSBI has been found to be a more accurate index than standard RSBI in predicting weaning of ill patients. The purpose of the present study was to determine the value of the Diaphragmatic Rapid Shallow Breathing Index in predicting unsuccessful weaning during spontaneous breathing and comparing it with RSBI. Materials and Methods: In Cross-Sectional study, 81 patients with intubation and mechanical ventilation <48 h and weaning criteria were enrolled in the study within 12 months. Patients with the same FIO2 who underwent mechanical ventilation underwent TPeice spontaneous breathing. 30 minutes after the start of SBT, right and left diaphragm ultrasound was performed and the patient was in a high head position. If ultrasound examination revealed paralyzed diaphragm or paradoxical movements. Two hours later, the physician decided to extubate or return to mechanical ventilation. During these two hours the RSBI index was calculated. Success was evaluated in the case of weaning for 48 h. Failure to do so during this period meant failure of weaning. Results: The mean age of the patients was 54.86±17.89 years. 51 patient (63%) was male and 30 (37%) female. Of the 81 patients studied, weaning was unsuccessful in 21 (25.9%) patients. The mean RSBI was 57.28±26.29. The mean RD-RSBI was 1.23±0.38 and LD-RSBI was 1.52±1.46. Diagnostic accuracy of RSBI in successful weaning was 78.2% and D-RSBI was 77.1%.