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Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning

[Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ≥1...

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Detalles Bibliográficos
Autores principales: Bien, Umilson dos Santos, Souza, Gerson Fonseca, Campos, Elisangela Siqueira, Farah de Carvalho, Etiene, Fernandes, Matheus Guedes, Santoro, Ilka, Costa, Dirceu, Arena, Ross, Sampaio, Luciana Maria Malosá
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Society of Physical Therapy Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4713778/
https://www.ncbi.nlm.nih.gov/pubmed/26834339
http://dx.doi.org/10.1589/jpts.27.3723
Descripción
Sumario:[Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ≥15 years who underwent orotracheal intubation for mechanical ventilation and who met the criteria of the weaning protocol were included in the study. Receiver operating characteristic (ROC) curves were calculated for the analysis of each index. [Results] Logistic regression analysis was also performed. MIP showed greater sensitivity and specificity [area under the curve (AUC): 0.95 vs. 0.89] and likelihood ratios (LR) (positive(+): 20.85 vs. 9.45; negative(−): 0.07 vs. 0.17) than RSBI in the overall sample (OS) as well as in clinical patients (CP) (AUC: 0.99 vs. 0.90; LR+: 24.66 vs. 7.22; LR-: 0.01 vs. 0.15) and surgical patients (SP) (AUC: 0.99 vs. 0.87; LR+: 9.33 vs. 5.86; LR−: 0.07 vs. 0.14). The logistic regression analysis revealed that both parameters were significantly associated with the weaning success. The MIP showed greater accuracy than the RSBI (OS: 0.93 vs. 0.85; CP: 0.98 vs. 0.87; SP: 0.93 vs. 0.87). [Conclusion] Both parameters are good predictors of successful ventilator weaning.