To Predict Weaning Outcomes Using Rapid Shallow Breathing Index and Ultrasound Guided Indices in Patients on Ventilator

INTRODUCTION: Mechanical ventilation is used to sustain respiratory function in patients with respiratory failure and when the cause improves, it should be discontinued as soon as possible. Numerous indices have been devised for the same, RSBI being the commonest. Diaphragmatic ultrasonography is a well-established bedside radiological tool having different parameters for assessment namely diaphragmatic excursion (DE), diaphragmatic thickening fraction (DTF) and diaphragmatic rapid shallow breathing index (D-RSBI). OBJECTIVES: To determine the weaning predictability in mechanically ventilated patients using RSBI, diaphragmatic excursion, diaphragm thickening fraction and D-RSBI assessed by ultrasonography.(1–3) MATERIAL AND METHODS: This is a prospective observational study carried out in the ICU of Venkateshwar Hospital, Dwarka, New Delhi with effect from September 2024. This study includes patients who were on mechanical ventilation for >48 hrs. A total of 36 patients will be included after taking written informed consent according to inclusion and exclusion criteria. RSBI is calculated along with the measurement of DE, DTF and D-RSBI at 5 and 30 mins after initiation of Spontaneous breathing trial (SBT) or immediately before returning to the initial ventilator settings in case of SBT failure. The clinician in charge decides whether to extubate/wean the patient from the ventilator based on institutional weaning protocol after 1 hour of SBT. The patients are divided into two groups i.e Weaning success or Weaning failure. RESULTS: The trend which is seen till now (which is with 10 patients) is that DE, DTF and D-RSBI are comparable with RSBI. As this is an ongoing study, towards the end of study, the statistical analysis will be more concrete and will be included in the final presentation.(4,5) DISCUSSION/CONCLUSION: Diaphragm ultrasound helps in predicting successful weaning in mechanically ventilated patients. DE, DTF and D-RSBI showed a similar predictability as RSBI.