What is it about?
The diaphragmatic rapid shallow breathing index (D-RSBI), which is the ratio between respiratory rate (RR) and the ultrasonographic evaluation of diaphragmatic displacement (DD), is a new and promising tool to predict weaning outcome. Its accuracy in predicting weaning failure, in ready-to-wean acute exacerbation COPD (AECOPD) patients, is needed to be validated
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Why is it important?
Invasive ventilation (IV) is essential among AECOPD patients to treat acute respiratory failure. In such cases, strategies should be implemented to discontinue IV as soon as possible to avoid time-dependent complications that may arise as a result of prolonged IV. Furthermore, extubation failure is associated with a risk of mortality, ranging from 40 to 50 %. Weaning failure is believed to be multifactorial. However, diaphragmatic dysfunction plays a major role in ventilator dependency. But, diaphragmatic function is still poorly assessed among critically ill patients. Although useful for research purposes, direct measurements of diaphragmatic strength are invasive and need considerable expertise. Diaphragmatic ultrasonography has recently been introduced as a non-invasive and bedside tool to measure diaphragmatic displacement (DD). Diaphragmatic dysfunction (defined as DD <10 mm) has been shown to be a good predictor of failure to wean from mechanical ventilation.this study concluded that D-RSBI (RR/DD) is superior to the traditional RSBI (RR/VT) in predicting weaning outcome in AECOPD patients.
Perspectives
Writing this article was a great pleasure as it has co-authors with whom I have had long standing collaborations. I hope that this article can be helpful in predicting weaning of COPD patients and reduces rates of failure and subsequent complications.
Ahmad Abbas
Zagazig University
Read the Original
This page is a summary of: Role of diaphragmatic rapid shallow breathing index in predicting weaning outcome in patients with acute exacerbation of COPD, International Journal of Chronic Obstructive Pulmonary Disease, May 2018, Dove Medical Press,
DOI: 10.2147/copd.s161691.
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