Effect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients

El-Khatib, Mohamad; Zeineldine, Salah; Jamaleddine, Ghassan

doi:10.1007/s00134-007-0939-x

Cited by 45 publications

(36 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, some clinicians leave the patient connected to the ventilator and calculate f/V T with the respiratory rate measured by the ventilator. 65 But because the ventilator does not detect ineffective efforts, the ventilator-measured respiratory rate will be lower than the true respiratory rate. As an example, if V T is 0.3 L and the ventilator-measured respiratory rate is 21 breaths/min, then f/V T is 70 breaths/min/L, which suggests that the patient is likely to pass a spontaneous breathing test.…”

Section: Effect Of Patient-ventilator Asynchrony On Outcomesmentioning

confidence: 99%

How Often Does Patient-Ventilator Asynchrony Occur and What Are the Consequences?

Epstein

2011

Respir Care

116

View full text Add to dashboard Cite

Mechanical ventilation can be life-saving for patients with acute respiratory failure. In between the 2 extremes of complete and no ventilatory support, both patient and machine contribute to ventilatory work. Ideally, ventilator gas delivery would perfectly match patient demand. This patientventilator interaction depends on how the ventilator responds to patient respiratory effort and, in turn, how the patient responds to the breath delivered by the ventilator. It is now evident that the interaction between patient and ventilator is frequently suboptimal and that patient-ventilator asynchrony is common. Its prevalence depends on numerous factors, including timing and duration of observation, technique used for detection, patient population, type of asynchrony, ventilation mode and settings (eg, trigger, flow, and cycle criteria), and confounding factors (eg, state of wakefulness, sedation). Patient-ventilator asynchrony is associated with adverse effects, including higher/wasted work of breathing, patient discomfort, increased need for sedation, confusion during the weaning process, prolonged mechanical ventilation, longer stay, and possibly higher mortality. Whether asynchrony is a marker of poor prognosis or causes these adverse outcomes remains to be determined.

show abstract

Section: Effect Of Patient-ventilator Asynchrony On Outcomesmentioning

confidence: 99%

How Often Does Patient-Ventilator Asynchrony Occur and What Are the Consequences?

Epstein

2011

Respir Care

116

View full text Add to dashboard Cite

show abstract

“…[5][6][7][8][9] The rapid shallow breathing index (RSBI) 3,10 and the out-comes of a spontaneous breathing trial (SBT) with either a T-piece or low-level pressure support ventilation (PSV) 11 are commonly used clinical methods. However, various thresholds and sensitivities of the RSBI exist among different patient populations and measurement conditions, [12][13][14] and 25-40% of patients who pass an SBT develop failure signs after being weaned from mechanical ventilation. 10,15,16 Weaning patients from ventilatory support is a complex issue.…”

Section: Introductionmentioning

confidence: 99%

Improvement in the Prediction of Ventilator Weaning Outcomes by an Artificial Neural Network in a Medical ICU

et al. 2015

View full text Add to dashboard Cite

“…They found that in the same patient with the use of PSV and/or PEEP as low as 5 cm H 2 0, smaller RSBI values were identified when compared with the ones measured during the T-piece. They found no effects from changes in FiO 2 on the RSBI values (21 O, the RSBI and f values increased and VT decreased, but this was not statistically significant. When PEEP was adjusted to 0, RSBI increased, but there was no significant change in f and VT values as the PS value was decreased.…”

Section: Yılmaz Et Al Rapid Shallow Breathing Index In Different Prementioning

confidence: 90%

“…These parameters did not vary when PSV was reduced from PSV 10 cm H 2 O to PSV 5 cm H 2 O (20). In a prospective study by El-Khatib et al (21), RSBI values under various ventilator support settings prior to extubation were evaluated. Similar to our study, they compared RSBI measured as 0 cm H 2 0 PSV/5 cm H 2 0 PEEP and 40% FiO 2 , 0 cm H 2 0 PSV/5 cm H 2 0 PEEP and 21% FiO 2 , and a 1 minute spontaneously breathing room air trial off the ventilator (T-piece).…”

Section: Yılmaz Et Al Rapid Shallow Breathing Index In Different Prementioning

confidence: 99%

Determining The Pressure Combination During Mechanical Ventilation that is Best Compatible with the Rapid Shallow Breathing Index Calculated in Spontaneous Ventilation

Yılmaz¹,

Aydoğdu²,

Gürsel³

2017

Eurasian J Pulmonol

View full text Add to dashboard Cite

Weaning is the process of decreasing ventilator support and allowing patients to assume a greater proportion of their spontaneous ventilation with the gradual reduction of ventilator support (1). In order to predict the patients' success in maintaining their spontaneous breathing and oxygenation, some parameters have been researched. Among these, the rapid shallow breathing index (RSBI) is the most studied and most accepted system with the highest predictive value (2, 3).Rapid shallow breathing index, the ratio of respiratory rate to tidal volume (f/VT), was first described by Yang and Tobin in 1990, as a parameter for weaning and extubation. A RSBI greater than 105 means that the patient is not ready for weaning off the ventilator (4). Moreover, a RSBI of less than 100-105 has yielded a sensitivity of 97% and a specificity of 65% for predicting weaning success (3). The evaluation of RSBI is valuable during T-tube ventilation; and in clinical practice it is not always possible to perform this assessment.In the present study, we aimed to estimate the patients' readiness toward weaning and to determine the pressure combination that is best compatible with the RSBI calculated by the original method, in which the measurement was done during no ventilator support. METHODS Patient PopulationIn this self-controlled and prospective study, the patients mechanically ventilated in an intensive care unit (ICU) were included in the study. The diagnosis of the patients and the underlying etiologies of their mechanical ventilation (MV) need were recorded. Ventilators were calibrated prior to intubation and then appropriate mechanical ventilator settings were done according to each patient's need. All the patients' age, gender, comorbid diseases, smoking history, diagnosis of intubation, intubation and extubation days, weaning trial day, weaning success, length of hospitalization, length of MV and ICU stay, need for re-intubation, outcome (exitus or discharge to home/ ward), and causes of mortality were recorded.

show abstract

Effect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients

Abstract: In the same patient the use of PSV and/or PEEP as low as 5 cmH2O can influence the RSBI. In contrast, changes in FIO2 may have no effect on the RSBI.

Cited by 45 publications

References 20 publications

How Often Does Patient-Ventilator Asynchrony Occur and What Are the Consequences?

How Often Does Patient-Ventilator Asynchrony Occur and What Are the Consequences?

Improvement in the Prediction of Ventilator Weaning Outcomes by an Artificial Neural Network in a Medical ICU

Determining The Pressure Combination During Mechanical Ventilation that is Best Compatible with the Rapid Shallow Breathing Index Calculated in Spontaneous Ventilation

Contact Info

Product

Resources

About