Effect of continuous positive airway pressure on the rapid shallow breathing index in patients following cardiac surgery.

Abstract:

OBJECTIVES:To compare the rapid shallow breathing index (RSBI) under different ventilatory support settings prior to extubation trials. DESIGN:Prospective study. SETTING:Cardiac surgery unit at a university hospital. PATIENTS:A total of 33 coronary artery bypass grafting patients ready for extubation. INTERVENTIONS:Enrolled patients received a continuous positive airway pressure (CPAP) trial of 5 cm H(2)O and fraction of inspired oxygen (FIO(2)) of 40% (condition 1), a CPAP trial of 5 cmH(2)O and FIO(2) of 21% (condition 2), and a 1-min spontaneously breathing room air trial without ventilatory support (condition 3). These trials were applied in random order. MEASUREMENTS AND MAIN RESULTS:Average values of respiratory frequency and tidal volume were measured under the three experimental conditions in all patients immediately prior to extubation. The RSBIs were determined for each patient under each condition; the average RSBIs under conditions 1, 2, and 3 were compared for significance. The average RSBIs (+/- SD) were significantly smaller under condition 1 (34 +/- 13) and condition 2 (36 +/- 14) compared to condition 3 (71 +/- 24). There was no significant difference in RSBI between conditions 1 and 2. CONCLUSIONS:The administration of 5 cm H(2)O of CPAP can influence the determination of the RSBI. In contrast, changes in FIO(2) have no effect on RSBI determination. We speculate that using the RSBI during CPAP may mislead the clinician into premature discontinuation of mechanical ventilation. Consequently, different threshold values for the RSBI should be derived for different ventilatory support levels.

journal_name

Chest

journal_title

Chest

authors

El-Khatib MF,Jamaleddine GW,Khoury AR,Obeid MY

doi

10.1378/chest.121.2.475

subject

Has Abstract

pub_date

2002-02-01 00:00:00

pages

475-9

issue

2

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)35453-8

journal_volume

121

pub_type

临床试验,杂志文章,随机对照试验

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