Comparação do índice de respiração rápida e superficial (IRRS) calculado de forma direta e indireta no pós-operatório de cirurgia cardíaca

Lessa, Fernando A. M.; Paes, Cilso D.; Tonella, Rodrigo Marques; Araújo, Sebastião

doi:10.1590/s1413-35552010000600009

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…We obtained the RSBI values from the ventilator display. It has been proven that RSBI calculated from values obtained by direct ventilometry and the one obtained through the display of the mechanical ventilator are highly correlated [ 26 ]. RSBI rate was calculated by using the following formula: (RSBI 2–RSBI 1)/RSBI 1 × 100, where RSBI 1 is the initial RSBI value (fifth minute) and RSBI 2 is the second value measured at the end of 120 minutes.…”

Section: Methodsmentioning

confidence: 99%

Rate of Change of Rapid Shallow Breathing Index and Extubation Outcome in Mechanically Ventilated Patients

Karthika,

Al Enezi,

Pillai

et al. 2023

Critical Care Research and Practice

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Background. Rapid shallow breathing index (RSBI) has been widely used as a predictor of extubation outcome in mechanically ventilated patients. We hypothesize that the rate of change of RSBI between the beginning and end of a 120-minute spontaneous breathing trial (SBT) could be a better predictor of extubation outcome than a single RSBI measured at the end of SBT in mechanically ventilated patients. Methodology. In this prospective observational study, we enrolled 193 patients who met the inclusion criteria, of whom 33 patients were unable to tolerate a 120-minute SBT and were excluded from the study. The study population consisted of 160 patients, categorized into three subgroups: patients with normal lung (no reported history of respiratory diseases), patients with airway disease, and patients with parenchymal disease who completed 120 minutes of SBT on low levels of pressure support ventilation. RSBI was obtained from the ventilator display at the 5th and the 120th minutes of SBT. The rate of change of RSBI (RSBI 5–120) was calculated as (RSBI 2-RSBI 1)/RSBI 1 × 100. Receiver-operating characteristic (ROC) curves were plotted for RSBI 5–120 and RSBI 120 in all patients and among the three subgroups (normal group, airway group, and parenchymal group) to compare the superiority of their best thresholds in predicting extubation failure. Results. The RSBI 5–120 threshold for extubation failure in the entire patient group was 23% with an overall accuracy of 88% (AUC = 0.933, sensitivity = 91%, and specificity = 86%) and the threshold of RSBI 120 for extubation failure in the entire patient group was 70 breaths/min/L with an overall accuracy of 82% (AUC = 0.899, sensitivity = 85%, and specificity = 81%). In patients in the normal lung group, the threshold of RSBI 5–120 was 22%, with an overall accuracy of 89% (AUC = 0.892, sensitivity = 87.5%, and specificity = 90%), and the RSBI 120 threshold was 70 breaths/min/L, with an overall accuracy of 89% (AUC = 0.956, sensitivity = 88%, and specificity = 90%). The RSBI 5–120 threshold in patients with airway disease was 25% with an accuracy of 86% (AUC = 0.892, sensitivity = 85%, and specificity = 86%) and the threshold of RSBI 120 was 73 breaths/min/L with an accuracy of 83% (AUC = 0.874, sensitivity = 85%, and specificity = 82%). In patients in the parenchymal disease group, the threshold of RSBI 5–120 was 24%, with an accuracy of 90% (AUC = 0.966, sensitivity = 92%, and specificity = 89%) and RSBI 120 threshold was 71 breaths/min/L, which was 88% accurate (AUC = 0.893, sensitivity = 85%, and specificity = 89%). Conclusion. The rate of change of RSBI between the 5th and 120th minutes was moderately more accurate than the single value of RSBI measured at the 120th minute in predicting extubation outcome.

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Section: Methodsmentioning

confidence: 99%

Rate of Change of Rapid Shallow Breathing Index and Extubation Outcome in Mechanically Ventilated Patients

Karthika,

Al Enezi,

Pillai

et al. 2023

Critical Care Research and Practice

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“…Inicialmente foram coletadas informações relacionadas ao sexo, idade, cor, IMC, tipo de cirurgia, intercorrências intraoperatórias, utilização de circulação extracorpórea e tempo de anoxia dos participantes da pesquisa, através do prontuário. Os participantes da pesquisa foram avaliados no período de pós-operatório de cirurgia cardíaca durante o processo de Ferraris -Europa/Reino Unido (Lessa et al, 2010). Para esta análise, o paciente foi posicionado em decúbito dorsal com elevação da cabeceira em 45°.…”

Section: Parâmetros Avaliadosunclassified

Avaliação Da Assistência Ventilatória Durante O Teste De Respiração Espontânea Em Pacientes No Pós-Operatório De Cirúrgica Cardíaca

Almeida,

Netto,

Mendes

et al. 2024

Rev. Contemp.

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As Doenças Cardiovasculares (DCV) são uma das principais causas de morte, com impacto significativo nos sistemas de saúde. Além de ser uma questão de saúde pública, o próprio tratamento em muitas das vezes é invasivo e gera impacto sobre os sistemas do paciente além do cardiovascular, de forma que muitos precisam passar pela cirurgia, onde eles são submetidos a ventilação mecânica, a avaliação dessa assistência durante o teste de respiração espontânea, parte fundamental do desmame, pode auxiliar na redução do tempo de VM, e consequente aumentar a taxa de sobrevida. Objetivo: A pesquisa teve como objetivo avaliar o nível de assistência ventilatória, utilizando medidas de variáveis não invasivas, durante o teste de respiração espontânea em pacientes no pós-operatório de cirurgia cardíaca. Método: Estudo transversal, prospectivo, observacional que comparou os parâmetros de P0,1, Pmus, DeltaPocc e Drive Pressure Transpulmonar nos momentos de 15 e 30 minutos do TRE de pacientes em PO de cirurgia cardíaca. Resultados: A maioria dos participantes era do sexo masculino e acima de 60 anos. A revascularização do miocárdio foi a cirurgia predominante. Os valores médios de P0,1 (p= 0,425), ΔPocc (p= 0,317), Pmus (p= 0,376) e DP transpulmonar (p= 0,197), foram semelhantes nos dois momentos estudados. Os valores de P0,1, ΔPocc, Pmus estavam abaixo da normalidade, sugerindo superassistência e DP transpulmonar dentro da normalidade. Apesar disso, todos os pacientes tiveram sucesso na extubação. Conclusão: A pesquisa destaca a importância de avaliar cuidadosamente a assistência ventilatória em pacientes pós-cirúrgicos cardíacos, considerando a possibilidade de superassistência. São necessários estudos adicionais para entender melhor os parâmetros ideais nesse cenário, explorando pressões mais baixas ou até mesmo a ausência delas.

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“…Some studies have indicated that calculating the RSBI using data from the ventilator can interfere with the value reached. 5 , 10 , 11 , 12 , 13 Obtaining it in PSV mode, even with low pressure levels, generates lower RSBI values than from spontaneous breathing with the use of the ventilometer. 5 , 11 , 13 , 14 , 15 , 16 When comparing the RSBI obtained by the ventilometer with the one from Continuous Positive Airway Pressure (CPAP) mode, the data are conflicting.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different methods of obtaining the rapid shallow breathing index

Duarte

França

Portes

et al. 2023

Brazilian Journal of Anesthesiology (English Edition)

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Comparação do índice de respiração rápida e superficial (IRRS) calculado de forma direta e indireta no pós-operatório de cirurgia cardíaca

Cited by 13 publications

References 26 publications

Rate of Change of Rapid Shallow Breathing Index and Extubation Outcome in Mechanically Ventilated Patients

Rate of Change of Rapid Shallow Breathing Index and Extubation Outcome in Mechanically Ventilated Patients

Avaliação Da Assistência Ventilatória Durante O Teste De Respiração Espontânea Em Pacientes No Pós-Operatório De Cirúrgica Cardíaca

Comparison of different methods of obtaining the rapid shallow breathing index

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