Low pressure support changes the rapid shallow breathing index (RSBI) in critically ill patients on mechanical ventilation

Abstract

Background: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the

The rapid shallow breathing index as a predictor of successful mechanical ventilation weaning: clinical utility when calculated from ventilator data

“… 8 This can be explained by advanced age (mean age, 62 ± 20 years), a high prevalence of patients with prolonged ventilation (mean duration of MV, 14.2 days), a high proportion of tracheostomized patients (43%), and high Acute Physiology and Chronic Health Evaluation II scores. 9 , 17 …”

“…This led to studies comparing the RSBI calculated by the traditional method with the RSBI calculated directly from ventilator data, significant differences being found between the two. 14 , 17 , 22 , 28 - 30 However, none of the aforementioned studies evaluated the performance of the RSBI (as calculated by each method) in predicting weaning success.…”

“…It has been proposed that the RSBI be calculated directly from ventilator data during spontaneous ventilation; however, because of the study design, the small number of patients enrolled, and the limitations of the statistical tests used, the results were inconclusive. 14 - 17 …”

“…Alguns autores se propuseram a medir esse índice com o uso direto de ventiladores mecânicos nos modos de ventilação espontânea; porém, devido ao desenho do estudo, ao baixo número de pacientes arrolados e às limitações dos testes estatísticos empregados, os resultados não foram conclusivos. 14 - 17 …”

Spontaneous breathing trial in T‐tube negatively impact on autonomic modulation of heart rate compared with pressure support in critically ill patients

“…As a consequence, there are changes in HR and a greater probability of hemodynamic instability , which may be held responsible for a higher incidence of myocardial ischemia during this period . In terms of clinical evolution, our patients who received the TT mode presented higher HR and SBP, with significant impact on ƒ/ V T ratio and SpO 2 . These responses can be more impact in patients diagnosed with chronic obstructive pulmonary disease and/or heart disease, which might require them to receive MV again .…”