Use of a Rapid Shallow Breathing Index from a Commercially Available Respiratory Monitor in Predicting Weaning of Ventilated Patients

以單一呼吸測量的淺快呼吸指數對加護病房的呼吸器離脫預測的正確性

王玠仁(Chieh-Jen Wang) ； 林芳杰(Fung-J Lin) ； 吳健樑(Chien-Liang Wu)

《胸腔醫學》 24卷4期 (2009/08) Pp. 186-192

https://doi.org/10.29806/TM.200908.0001

摘要

Objective: Frequency-to-tidal volume ratio (f/Vt) has been widely used as a weaning predictor for years. A method using a hand-held monitor with an automatic f/Vt calculation was tested in this study to verify its clinical application.
Design: This was a prospective study of 102 respiratory failure patients ready for weaning in a 15-bed adult medical intensive care unit (ICU). Two f/Vt measurements were taken daily: 1 by the standard manual calculation (Yang's method) and the other by the VentCheck(superscript TM) monitor. Weaning was considered successful if the patient tolerated 2-hour trials without distress and remained free from mechanical ventilation for at least 48 hours. The patients were divided into successfully and unsuccessfully weaned groups. The sensitivity, specificity, and likelihood ratio of these predictors were calculated and the data were analyzed with an ROC curve to examine accuracy.
Results: The overall weaning success rate was 67.6%. There were no significant differences in the APACHE Ⅱ score, age, gender, and diagnosis between the 2 groups. Sensitivity and accuracy were higher for Yang's method (traditional) than the 1-minute f/Vt (91.3% vs. 81.2% and 82.4% vs. 79.4%, respectively), but the areas under the ROC curve were similar for both measurements (0.86).
Conclusions: The 1 minute f/Vt using the VentCheck(superscript TM) monitor is comparable to Yang's method in predicting successful weaning of ICU patients.

關鍵字

淺快呼吸指數 ； 離脫參數 ； 機械性通氣輔助 ； 自主呼吸測試

並列摘要

Objective: Frequency-to-tidal volume ratio (f/Vt) has been widely used as a weaning predictor for years. A method using a hand-held monitor with an automatic f/Vt calculation was tested in this study to verify its clinical application.
Design: This was a prospective study of 102 respiratory failure patients ready for weaning in a 15-bed adult medical intensive care unit (ICU). Two f/Vt measurements were taken daily: 1 by the standard manual calculation (Yang's method) and the other by the VentCheck(superscript TM) monitor. Weaning was considered successful if the patient tolerated 2-hour trials without distress and remained free from mechanical ventilation for at least 48 hours. The patients were divided into successfully and unsuccessfully weaned groups. The sensitivity, specificity, and likelihood ratio of these predictors were calculated and the data were analyzed with an ROC curve to examine accuracy.
Results: The overall weaning success rate was 67.6%. There were no significant differences in the APACHE Ⅱ score, age, gender, and diagnosis between the 2 groups. Sensitivity and accuracy were higher for Yang's method (traditional) than the 1-minute f/Vt (91.3% vs. 81.2% and 82.4% vs. 79.4%, respectively), but the areas under the ROC curve were similar for both measurements (0.86).
Conclusions: The 1 minute f/Vt using the VentCheck(superscript TM) monitor is comparable to Yang's method in predicting successful weaning of ICU patients.

並列關鍵字

rapid shallow breathing index ； weaning predictors ； mechanical ventilation ； spontaneous breathing trial