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Intensive Care Medicine

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01-03-2008 | Original

Effect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients

Authors: Mohamad F. El-Khatib, Salah M. Zeineldine, Ghassan W. Jamaleddine

Published in: Intensive Care Medicine | Issue 3/2008

Abstract

Objective

We compared rapid shallow breathing index (RSBI) values under various ventilatory support settings prior to extubation.

Design and setting

Prospective study in the intensive care unit at a university hospital.

Patients

Thirty six patients ready for extubation.

Interventions

Patients were enrolled when receiving pressure support ventilation (PSV) of 5 cmH₂O, PEEP of 5 cmH₂O, and FIO₂ of 40% (PS). Subsequently each patient received a trial of PSV of 0 cmH₂O, PEEP of 5 cmH₂O, and FIO₂ of 40% (CPAP), a trial of PSV of 0 cmH₂O, PEEP of 5 cmH₂O and FIO₂ of 21% (CPAP-R/A), and a 1-minute spontaneously breathing room air trial off the ventilator (T-piece). Trials were carried out in random order.

Measurements and results

Respiratory frequency (f) and tidal volume (V_T) were measured during PS, CPAP, CPAP-R/A, and T-piece in all patients. RSBI (f/V_T) was determined for each patient under all experimental conditions, and the average RSBI was compared duringPS, CPAP, CPAP-R/A, and T-piece. RSBI was significantly smaller during PS (46 ± 8bpm/l), CPAP (63 ± 13bpm/l) and CPAP-R/A (67 ± 14bpm/l) vs. T-piece (100 ± 23bpm/l). There was no significant difference in RSBI between CPAP and CPAP-R/A. RSBI during CPAP and CPAP-R/A were significantly smaller than RSBI during T-piece. In all patients RSBI values were less than 105 bpm/l during PS, CPAP, and CPAP-R/A. However, during T-piece the RSBI increased to greater than 105 bpm/l in 13 of 36 patients.

Conclusions

In the same patient the use of PSV and/or PEEP as low as 5 cmH₂O can influence the RSBI. In contrast, changes in FIO₂ may have no effect on the RSBI.

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Title: Effect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients
Authors: Mohamad F. El-Khatib
Salah M. Zeineldine
Ghassan W. Jamaleddine
Publication date: 01-03-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0939-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients

Abstract

Objective

Design and setting

Patients

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients

Interventions

Measurements and results

Conclusions

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