Association between the rapid shallow breathing index and extubation success in patients with traumatic brain injury

Abstract

ObjectiveTo investigate the association between the rapid shallow breathing index and successful extubation in patients with traumatic brain injury. MethodsThis study was a prospective study conducted in patients with traumatic brain injury of both genders who underwent mechanical ventilation for at least two days and who passed a spontaneous breathing trial. The minute volume and respiratory rate were measured using a ventilometer, and the data were used to calculate the rapid shallow breathing index (respiratory rate/tidal volume). The dependent variable was the extubation outcome: reintubation after up to 48 hours (extubation failure) or not (extubation success). The independent variable was the rapid shallow breathing index measured after a successful spontaneous breathing trial. ResultsThe sample comprised 119 individuals, including 111 (93.3%) males. The average age of the sample was 35.0±12.9 years old. The average duration of mechanical ventilation was 8.1±3.6 days. A total of 104 (87.4%) participants achieved successful extubation. No association was found between the rapid shallow breathing index and extubation success. ConclusionThe rapid shallow breathing index was not associated with successful extubation in patients with traumatic brain injury.

Principais Causas De Falha Na Extubação De Pacientes Internados Em Um Centro De Terapia Intensiva Adulto De Um Hospital Do Interior De Minas Gerais

“…Em outro estudo de Reis, Almeida, Silva, Moreira, & Rocha (2013), foram incluídos 119 pacientes com TCE elegíveis para extubação. As causas de reintubação foram: insuficiência respiratória em 46,7%, laringoespasmo 26,7%; redução do nível de consciência 13,3%, excesso de secreção 6,7%, e sepse em 6,7% dos pacientes.…”

Interferência Do Balanço Hidroeletrolítico No Desfecho Do Desmame Ventilatório

“…O estudo mostrou também que o grupo de sucesso teve permanência mais curta em VM (13) . Alguns outros preditores de falha de extubação foram citados na literatura, como a idade avançada, acúmulo de secreção e a incapacidade de expelir por meio da tosse, disfunção cardiovascular, comprometimento neurológico, nível de consciência deprimido, tempo prolongado em VM, hipercapnia, edema de laringe (1,14) , alteração da mecânica respiratória, por resistência alta ou complacência baixa, congestão pulmonar, aumento de demanda de oxigênio, atrofia muscular por desuso, polineuromiopatia do paciente crítico, distúrbios hidroeletrolíticos, broncoespasmo, broncoaspiração, atelectasia, infecção respiratória, entre outros (18)(19)(20)(21) . A falha de extubação tem sido associada ao prolongamento do tempo de permanência em UTIs e hospitais, assim como a maiores taxas de traqueostomia e de mortalidade (19,21) .…”

Application of mechanical ventilation weaning predictors after elective cardiac surgery

“…Tobin Index (f/V t ) is considered the most sensitive parameter for predicting weaning success [ 10 , 12 , 14 , 20 , 21 ] , supporting our findings. However, research has demonstrated that this index is not as accurate [ 22 - 26 ] . This is explained by differences in the studied populations, which lead to variation in pretest probability and, consequently, test referral bias [ 27 ] .…”