The Timed Inspiratory Effort: A Promising Index of Mechanical Ventilation Weaning for Patients With Neurologic or Neuromuscular Diseases

Souza, Leonardo Cordeiro de; Guimarães, Fernando Silva; Lugon, Jocemir Ronaldo

doi:10.4187/respcare.03393

Cited by 14 publications

(46 citation statements)

References 33 publications

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“…Promising new weaning indices include the integrative weaning index, the AUC for which was found to be 0.96 in a study from which neurological patients were excluded, 11 and the TIE index, the AUC for which was found to be 0.90 for a mixed population of intubated patients and 0.96 for patients with neurological or neuromuscular disease. 4 , 13 …”

Section: Discussionmentioning

confidence: 99%

“… 2 , 23 , 25 , 31 Therefore, the use of predictors such as f/V T , MIP, the integrative weaning index, and the recently described TIE index can make the outcome of weaning from MV safer, especially in difficult-to-wean patients. 4 , 11 , 13 , 24 …”

Section: Discussionmentioning

confidence: 99%

“…The rapid shallow breathing index (RSBI), which is also referred to as the ratio of respiratory rate to tidal volume (f/V T ), is the most widely used predictor of weaning success because it is easy to use and interpret. 1 , 4 , 7 - 13 The 2007 international consensus guidelines for weaning from MV, the 2007 Brazilian consensus guidelines for weaning from MV, and the 2013 Brazilian guidelines for MV underscore the clinical utility of the RSBI and recommend its use. 5 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

“…In such cases, the performance of the RSBI is far worse than that of other predictors, such as the Glasgow Coma Scale score and the recently described timed inspiratory effort (TIE) index. 4 , 12 , 13 , 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

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

Souza

Lugon

2015

J. bras. pneumol.

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OBJECTIVE: The use of the rapid shallow breathing index (RSBI) is recommended in ICUs, where it is used as a predictor of mechanical ventilation (MV) weaning success. The aim of this study was to compare the performance of the RSBI calculated by the traditional method (described in 1991) with that of the RSBI calculated directly from MV parameters. METHODS: This was a prospective observational study involving patients who had been on MV for more than 24 h and were candidates for weaning. The RSBI was obtained by the same examiner using the two different methods (employing a spirometer and the parameters from the ventilator display) at random. In comparing the values obtained with the two methods, we used the Mann-Whitney test, Pearson's linear correlation test, and Bland-Altman plots. The performance of the methods was compared by evaluation of the areas under the ROC curves. RESULTS: Of the 109 selected patients (60 males; mean age, 62 ± 20 years), 65 were successfully weaned, and 36 died. There were statistically significant differences between the two methods for respiratory rate, tidal volume, and RSBI (p < 0.001 for all). However, when the two methods were compared, the concordance and the intra-observer variation coefficient were 0.94 (0.92-0.96) and 11.16%, respectively. The area under the ROC curve was similar for both methods (0.81 ± 0.04 vs. 0.82 ± 0.04; p = 0.935), which is relevant in the context of this study. CONCLUSIONS: The satisfactory performance of the RSBI as a predictor of weaning success, regardless of the method employed, demonstrates the utility of the method using the mechanical ventilator.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Souza

Lugon

2015

J. bras. pneumol.

View full text Add to dashboard Cite

show abstract

“…To improve the performance of the mechanical ventilator weaning, new indexes 11,12 have been proposed and applied to different populations. 13 The objective of this study is to evaluate the variables associated with successful weaning from mechanical ventilation in elderly subjects, observing traditional predictors and the integrative weaning index (IWI). For this purpose, we compared the weaning outcome in elderly (Ն70 y old) and non-elderly subjects (Ͻ70 y old).…”

Section: Introductionmentioning

confidence: 99%