Shunsuke Takaki1, Suhaini Bin Kadiman2, Sharifah Suraya Tahir2, M Hassan Ariff2, Kiyoyasu Kurahashi3, Takahisa Goto3. 1. Department of Anesthesiology, Yokohama City University Hospital, Japan. Electronic address: shunty5323@gmail.com. 2. Department of Anesthesiology, National Heart Center in Malaysia (Institute Jantung Negara), Malaysia. 3. Department of Anesthesiology, Yokohama City University Hospital, Japan.
Abstract
OBJECTIVE: The aim of this study was to determine the best predictors of successful extubation after cardiac surgery, by modifying the rapid shallow breathing index (RSBI) based on patients' anthropometric parameters. DESIGN: Single-center prospective observational study. SETTING: Two general intensive care units at a single research institute. PARTICIPANTS: Patients who had undergone uncomplicated cardiac surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The following parameters were investigated in conjunction with modification of the RSBI: Actual body weight (ABW), predicted body weight, ideal body weight, body mass index (BMI), and body surface area. Using the first set of patient data, RSBI threshold and modified RSBI for extubation failure were determined (threshold value; RSBI: 77 breaths/min (bpm)/L, RSBI adjusted with ABW: 5.0 bpm×kg/mL, RSBI adjusted with BMI: 2.0 bpm×BMI/mL). These threshold values for RSBI and RSBI adjusted with ABW or BMI were validated using the second set of patient data. Sensitivity values for RSBI, RSBI modified with ABW, and RSBI modified with BMI were 91%, 100%, and 100%, respectively. The corresponding specificity values were 89%, 92%, and 93%, and the corresponding receiver operator characteristic values were 0.951, 0.977, and 0.980, respectively. CONCLUSIONS: Modified RSBI adjusted based on ABW or BMI has greater predictive power than conventional RSBI.
OBJECTIVE: The aim of this study was to determine the best predictors of successful extubation after cardiac surgery, by modifying the rapid shallow breathing index (RSBI) based on patients' anthropometric parameters. DESIGN: Single-center prospective observational study. SETTING: Two general intensive care units at a single research institute. PARTICIPANTS: Patients who had undergone uncomplicated cardiac surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The following parameters were investigated in conjunction with modification of the RSBI: Actual body weight (ABW), predicted body weight, ideal body weight, body mass index (BMI), and body surface area. Using the first set of patient data, RSBI threshold and modified RSBI for extubation failure were determined (threshold value; RSBI: 77 breaths/min (bpm)/L, RSBI adjusted with ABW: 5.0 bpm×kg/mL, RSBI adjusted with BMI: 2.0 bpm×BMI/mL). These threshold values for RSBI and RSBI adjusted with ABW or BMI were validated using the second set of patient data. Sensitivity values for RSBI, RSBI modified with ABW, and RSBI modified with BMI were 91%, 100%, and 100%, respectively. The corresponding specificity values were 89%, 92%, and 93%, and the corresponding receiver operator characteristic values were 0.951, 0.977, and 0.980, respectively. CONCLUSIONS: Modified RSBI adjusted based on ABW or BMI has greater predictive power than conventional RSBI.
Authors: Reza Goharani; Amir Vahedian-Azimi; Iman H Galal; Leonardo Cordeiro de Souza; Behrooz Farzanegan; Farshid R Bashar; Michele Vitacca; Seyedpouzhia Shojaei; Seyed M M Mosavinasab; Shunsuke Takaki; Andrew C Miller Journal: J Thorac Dis Date: 2019-04 Impact factor: 2.895