PREDICTING POST-EXTUBATION RESPIRATORY FAILURE AFTER MYOCARDIAL INFARCTION USING THE RAPID SHALLOW BREATHING INDEX AND LUNG ULTRASOUND SCORE
DOI:
https://doi.org/10.55519/JAMC-03-10921Keywords:
acute myocardial infarction, extubation, noninvasive ventilation, rapid shallow breathing index, lung ultrasound scoreAbstract
Background: The Rapid Shallow Breathing Index (RSBI) has been hypothesized to have discriminating power for categorizing patients at higher risk of post-extubation respiratory failure (RF). Hence aim of this study was to determine the predictive value of RSBI for post-extubation RF in patients after acute myocardial infarction (AMI). Methods: Consecutive, intubated patients admitted post-revascularization were included. RSBI and lung ultrasound score (LUS) were measured and post-extubation RF within 48 hours was recorded. Results: RF was observed in 36.3% (78/215) patients. For the prediction of RF, RSBI and LUS had area under the curve of 0.670 and 0.635, respectively. The sensitivity, specificity, negative predictive value, and positive predictive value of RSBI >50.5 were 75.6%, 54.7%, 79.8%, and 48.8% respectively, while, the accuracy measures for the combination of RSBI with LUS >1.5 were 44.9%, 84.7%, 73.0%, and 62.5% respectively. Conclusion: Combined RSBI and LUS measured during spontaneous breathing trial in patients after an AMI, have high predictive abilities for identifying post-extubation RF.
References
Vallabhajosyula S, Kashani K, Dunlay SM, Vallabhajosyula S, Vallabhajosyula S, Sundaragiri PR, et al. Acute respiratory failure and mechanical ventilation in cardiogenic shock complicating acute myocardial infarction in the USA, 2000-2014. Ann Intensive Care 2019;9(1):96.
Keenan SP, Sinuff T, Burns KE, Muscedere J, Kutsogiannis J, Mehta S, et al. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ 2011;183(3):E195-214.
Burns KE, Adhikari NK, Keenan SP, Mead MO. Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure. Cochrane Database Syst Rev 2010;4:CD004127.
Burns KE, Adhikari NK, Keenan SP, Mead M. Use of noninvasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review. BMJ 2009;338:b1574.
Antonelli M, Bello G. Noninvasive mechanical ventilation during the weaning process: facilitative, curative or preventive. Crit Care 2008;12(2):136.
Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet 2009;374(9685):250-9.
Nava S, Ambrosino N, Clini E, Prato M, Orlando G, Vitacca M, et al. Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease: a randomized, controlled trial. Ann Intern Med 1998;128(9):721-8.
Ferrer M, Sellarés J, Valencia M, Carrillo A, Gonzalez G, Badia JR, et al. Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial. Lancet 2009;374(9695):1082-8.
Ferrer M, Esquinas A, Arancibia F, Bauer TT, Gonzalez G, Carrillo A, et al. Noninvasive ventilation during persistent weaning failure: a randomized controlled trial. Am J Respir Crit Care Med 2003;168(1):70-6.
Chen J, Qiu D, Tao D. Time for extubation and sequential noninvasive mechanical ventilation in COPD patients with exacerbated respiratory failure who received invasive ventilation. Zhonghua Jie He Hu Xi Za Zhi 2001;24(2):99-100.
Hill NS, Lin D, Levy M. Noninvasive positive pressure ventilation (NPPV) to facilitate extubation after acute respiratory failure: a feasibility study. Am J Respir Crit Care Med 2000;161(3):A263.
Girault C, Daudenthun I, Chevron V, Tamion F, Leroy J, Bonmarchand G. Noninvasive ventilation as a systematic extubation and weaning technique in acute-on-chronic respiratory failure: a prospective, randomized controlled study. Am J Respir Crit Care Med 1999;160(1):86-92.
Trevisan CE, Vieira SR, Research Group in Mechanical Ventilation Weaning. Noninvasive mechanical ventilation may be useful in treating patients who fail weaning from invasive mechanical ventilation: a randomized clinical trial. Crit Care 2008;12(12):R51.
Rabie GM, Mohamed AZ, Mohamed RN. Noninvasive ventilation in the weaning of patients with acute-on-chronic respiratory failure due to COPD. Chest 2004;126(4):755.
Wang C, Zhang Q, Cao Z. Pulmonary infection control window in the treatment of severe respiratory failure of chronic obstructive pulmonary diseases: a prospective, randomized controlled, multi-centre study. Chin Med J (Engl) 2005;118(19):1589-94.
Ornico SR, Lobo SM, Sanches HS, Deberaldini M, Tófoli LT, Vidal AM, et al. Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial. Crit Care 2013;17(2):R39.
Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 1991;324(21):1445-50.
Soleimanpour H, Taghizadieh A, Salimi R, Golzari SE, Mahmoodpoor A, Safari S, et al. Rapid shallow breathing index survey, a predictor of non-invasive ventilation necessity in patients with chronic obstructive pulmonary disease exacerbation: An analytical descriptive prospective study. Iran Red Crescent Med J 2014;16(2):e13326.
Berg KM, Lang GR, Salciccioli JD, Bak E, Cocchi MN, Gautam S, et al. The rapid shallow breathing index as a predictor of failure of noninvasive ventilation for patients with acute respiratory failure. Respir Care 2012;57(10):1548-54.
Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol 2018;72(18):2231-64.
Soummer A, Perbet S, Brisson H, Arbelot C, Constantin JM, Lu Q, et al. Lung Ultrasound Study Group. Ultrasound assessment of lung aeration loss during a successful weaning trial predicts postextubation distress. Crit Care Med 2012;40(7):2064-72.
Caille V, Amiel JB, Charron C, Belliard G, Vieillard-Baron A, Vignon P. Echocardiography: a help in the weaning process. Crit Care 2010;14(3):R120.
Cabello B, Thille AW, Roche-Campo F, Brochard L, Gómez FJ, Mancebo J. Physiological comparison of three spontaneous breathing trials in difficult-to-wean patients. Intensive Care Med 2010;36(7):1171-9.
Terzi N, Lofaso F, Masson R, Beuret P, Normand H, Dumanowski E, et al. Physiological predictors of respiratory and cough assistance needs after extubation. Ann Intensive Care 2018;8(1):18.
Frutos-Vivar F, Ferguson ND, Esteban A, Epstein SK, Arabi Y, ApezteguÃa C, et al. Risk factors for extubation failure in patients following a successful spontaneous breathing trial. Chest 2006;130(6):1664-71.
Capucci A, Molon G, Gold MR, Zhang Y, Sweeney R, Averina V, et al. Rapid shallow breathing worsens prior to heart failure decompensation. J Card Fail 2014;20(8):S14.
Takaki S, Kadiman SB, Tahir SS, Ariff MH, Kurahashi K, Goto T. Modified rapid shallow breathing index adjusted with anthropometric parameters increases predictive power for extubation failure compared with the unmodified index in postcardiac surgery patients. J Cardiothorac Vasc Anesth 2015;29(1):64-8.
Oribabor CE, Mansuroglu N, Khusid F, Patten A, Suleiman M, Primiano J, et al. Low extubation times in cardiac surgery patients using the rapid shallow breathing index. Chest 2005;128(4):S273.
Ferré A, Guillot M, Lichtenstein D, Mezière G, Richard C, Teboul JL, et al. Lung ultrasound allows the diagnosis of weaning-induced pulmonary oedema. Intensive Care Med 2019;45(5):601-8.
Scali MC, Zagatina A, Ciampi Q, Cortigiani L, D'Andrea A, Daros CB, et al. Lung ultrasound and pulmonary congestion during stress echocardiography. JACC Cardiovasc Imaging 2020;13(10):2085-95.
Bellone A, Barbieri A, Ricci C, Iori E, Donateo M, Massobrio M, et al. Acute effects of non-invasive ventilatory support on functional mitral regurgitation in patients with exacerbation of congestive heart failure. Intensive Care Med 2002;28(9):1348-50.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
