Rapid and shallow breathing index to predict extubation success—COBRE-US trial

<bold>Background:</bold> The rapid and shallow breathing index (RSBI) results are employed to forecast the success of the spontaneous breathing trial (SBT) and subsequent extubation. <bold>Methods:</bold> In a prospective and multicenter study, we assessed the predictive capacity of RSBI for SBT success and extubation. RSBI, calculated as the ratio of tidal volume to respiratory frequency (f/VT), was evaluated immediately after the cuff leak test during the transition to spontaneous mode. Receiver operating characteristic (ROC) curves were utilized for predictive ability evaluation. <bold>Results:</bold> A total of 367 subjects undergoing invasive mechanical ventilation underwent 456 SBTs, achieving a success rate of 76.5%. The ROC curve yielded an area under the curve (AUC) of 0.53 (95%CI:0.50-0.55;p=0.161), suggesting that RSBI lacks discriminative capacity for SBT success prediction (figure 1). Similarly, the AUC for extubation was 0.48 (95%CI:0.46-0.50;p=0.317), indicating RSBI inadequacy in predicting extubation success (Figure 2). <bold>Conclusions:</bold> The discriminative capacity of the RSBI to predict the success of the SBT and successful extubation is limited, so its routine use in daily clinical practice is not recommended. <fig><object-id>erj;64/suppl_68/PA3903/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>