Journal of Health Science and Medical Research (JHSMR) (Aug 2016)
Comparative Study of the Success Rate of Mechanical Ventilator Liberation between Applying and not Applying Rapid Shallow Breathing Index (RSBI) in Patients with Acute Respiratory Failure after Passing Clinical Readiness Assessment
Abstract
Objective: To compare the success rate of mechanical ventilator liberation between the application of rapid shallow breathing index (RBSI) and no RSBI application in patient with acute respiratory failure who passed the clinical readiness assessment for mechanical ventilator liberation. Material and Methods: This is a prospective single arm study in patients with acute respiratory failure who required mechanical ventilator support in the medical intensive care unit after passed the standard unit clinical readiness assessment. All patients were, then, measured RSBI by Intensive Care Unit (ICU) nurses and the results of RSBI were blinded to the researcher. Afterward, the standard mechanical ventilator liberation processes were, then, performed regardless of RSBI results and continuously monitored the clinical statuses indicated successful of mechanical ventilator liberation. The patients who tolerated the standard mechanical liberation processes for 120 minutes, were defined as successful mechanical ventilator liberation. Afterward, selected patients with RSBI less than 105 were then determined with the clinical readiness assessment to compare the success rate of mechanical ventilator liberation between utilized and not utilized RSBI by t-test. This study protocol was approved by the Ethical Committee at Faculty of Medicine, Prince of Songkla University. Results: One hundred and twenty patients, who passed the standard clinical readiness assessment for mechanical ventilator liberation, were recruited. We found that the success rate of mechanical ventilator of the patient regardless of RSBI determination was 89.2%. In the selected patients with RSBI less than 105 after passing the clinical readiness assessment, the success rate of mechanical ventilator liberation was increased to 92.2%, but no statistically significant was found. Conclusion: Although, the application of RSBI below 105 to the patients with acute respiratory failure who meet the clinical readiness criteria increased the success rate of mechanical ventilator liberation, but no statistically significant was found.
