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Am J Med Sci ; 359(2): 117-122, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32039763

RESUMO

BACKGROUND: This study aimed to compare the effect of using versus not using the Rapid-Shallow Breathing Index (RSBI) as a readiness criterion for Spontaneous Breathing Trials (SBT) on SBT success. MATERIALS AND METHODS: Daily readiness screens were performed within a respiratory therapist-driven weaning protocol. Patients who passed these screens underwent a one-time measurement of the RSBI and then a SBT regardless of RSBI result. The proportion of passed readiness screens reaching SBT success was compared to the proportion that would have been obtained if RSBI ≤ 105 br/min/L had been used as an additional screen criterion. RESULTS: Two hundred and fifty SBTs performed on 157 patients were analyzed. The sensitivity of RSBI ≤ 105 br/min/L to predict SBT success was 94.8% (95% CI 90.6-97.5). Relative to potentially using RSBI, 14.4% additional SBTs were performed. A third of these were successful, and no complications were detected in the rest that failed. The proportion of passed readiness screens reaching SBT success would have been 4% (95% CI 1.2-6.8) (P = 0.002) lower if RSBI had been used. CONCLUSIONS: The inclusion of the RSBI in a readiness screen may not be useful in a weaning protocol.


Assuntos
Mecânica Respiratória , Desmame do Respirador , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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