The Usefulness of the Rapid Shallow Breathing Index in Predicting Successful Extubation: A Systematic Review and Meta-analysis.

Background Clinicians use several measures to ascertain whether individual patients will tolerate liberation from mechanical ventilation, including the rapid shallow breathing index (RSBI). Research Question Given varied use of different thresholds, patient populations, and measurement characteristics, how well does RSBI predict successful extubation? Study Design and Methods We searched six databases from inception through September 2019 and selected studies reporting the accuracy of RSBI in the prediction of successful extubation. We extracted study data and assessed quality independently and in duplicate. Results We included 48 studies involving RSBI measurements of 10,946 patients. Pooled sensitivity for RSBI of  Interpretation As a stand-alone test, the RSBI has moderate sensitivity and poor specificity for predicting extubation success. Future research should evaluate its role as a permissive criterion to undergo a spontaneous breathing trial (SBT) for patients who are at intermediate pretest probability of passing an SBT. Trial Registry PROSPERO; No.: CRD42020149196