Comparison between IWI and RSBI indexes in predicting ventilator isolation in ICU patients

Abstract

Weaning is the process of liberating the patient from mechanical ventilation. Weaning by intensive care physician’s bedside clinical discretion alone can sometimes lead to extubation failure. Yang–Tobin index, also known as the rapid shallow breathing index (RSBI) and integrative weaning index (IWI), are two of the most commonly used weaning indices in intensive care units (ICUs). We did a comparative study between the two indices for the prediction of successful weaning in mechanically ventilated patients. Materials and methods: In this cross-sectional and analytical study 130 ICU patients in Imam Reza hospital of Tabriz between June 2023- March 2024 who were mechanically ventilated for >48 hours and were ready for extubation included. The required information was recorded and collected by examining medical records. The relevant information was entered into the SPSS version 22 software and evaluated at a significance level of less than 0.05 based on the objectives of the study. Results: The median age of the patients in the study was 50±7.49 years old, 100 (76.9%) of whom were male and 30 (23.1%) were female. Based on data obtained from SPSS, if you consider the threshold for isolation prediction with the Youden index 79.91 for RSBI sensitivity 76.19 with CI95% (54.91%-89.37%) and specify 94.50 feature is reported with CI95% (88.51%-97.45%). Also, according to AUC 0.79 with St. Error 0.076 along with CI 95% (0.64-0.94) (P<0.0001) reported. P.P.V for RSBI: 7/72% and N.P.V was 94/50. With considering threshold isolation projections with the index of Youden less than 41.20 for IWI, the sensitivity is 90.48 with CI95% (98.31%-71.09%) and specify 94.50 is reported with CI95% (97.45%-88.51%). Also, according to AUC 0.95 with St. Error 0.02521 along with CI 95% (0.99-.0.90) (P<0.0001) reported. P.P.V for IWI: 76% and N.P.V for IWI: 98.1. According to the data obtained by RSBI, (P=0.000), it has been reported to show a significant difference between two successful and unsuccessful separation groups. p value has also been reported in IWI. According to (P=0.000) for length of hospitalization, this variable is also effective in predicting successful or unsuccessful isolation. P value for data PaCO2 value (0.000) is reported. According to the table 9, the value of P for other variables is above 0.05. According to statistics obtained from SPSS, the average IWI was reported in patients who had successful weaning 77.56±17.41, and 27.57±10.51. In the case of RSBI index, the average successful separation was 58.64±10.51 and in the unsuccessful extubation 89.40±21.13. In the case of the variable length of hospitalization in people who had successful weaning was 25.44±2.82 days, and in the unsuccessful separation was 28.33±1.62days. The average value for PaCO2 has been reported in people with successful separation of 39.73±3.77, and in people with unsuccessful separation of 46.80±3.18.