Efficacy of the rapid shallow breathing index method using ventilator parameters in extubation success

Introduction: the Rapid Shallow Breathing Index (RSBI) is one of the most widely used predictors of extubation outcomes, and the parameters originally used for its calculation were obtained using a ventilometer. Objective: To compare extubation failure associated with the use of RSBI obtained from ventilator parameters versus a ventilometer in mechanically ventilated patients. Methods: A prospective, longitudinal observational study was conducted including adult patients who had been receiving mechanical ventilation for at least 24 hours and underwent a spontaneous breathing trial. Two methods were used to obtain the RSBI: ventilator-derived parameters during pressure support ventilation and measurements obtained using a ventilometer. Randomization determined which RSBI value would be provided to the physiotherapist responsible for the extubation decision, defining two groups: patients extubated based on the RSBI obtained using a ventilometer (ventilometer group) and patients extubated based on ventilator-derived parameters (ventilator group). Outcomes assessed included extubation failure, intensive care unit (ICU) length of stay, hospital length of stay, and mortality. Results: Forty-nine patients were included. RSBI values were significantly lower when obtained from ventilator parameters. The extubation failure rate was 11.5% in the ventilator group and 26.1% in the ventilometer group, with no statistically significant difference. No significant differences were observed between the groups regarding ICU length of stay, hospital length of stay, or mortality. Conclusion: No differences were observed between the groups regarding extubation failure, mortality, ICU length of stay, or hospital length of stay.