Prospective assessment of the ability of rapid shallow breathing index computed during a pressure support spontaneous breathing trial to predict extubation failure in ICU

As the objective clinical criteria [ 1 ] are imperfect to assess patients before extubation, simple physiological parameters are used to try to improve extubation failure (EF) prediction. The rapid shallow breathing index (RSBI) (respiratory rate (RR) over tidal volume (VT) ratio) recorded during a T-piece spontaneous breathing trial (SBT) is known as the most reliable physiologic predictor. However, RSBI is nowadays usually computed during a pressure support (PS) SBT using the values displayed on the ventilator screen and not based on spirometry measurements without any assist as initially published. The aim of the present study was to prospectively assess the ability of currently measured RSBI to predict EF.