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Objective <p>To characterize dynamic changes in the weight-adjusted rapid shallow breathing index (RSBI) during a 60-min spontaneous breathing trial (SBT) in mechanically ventilated preterm infants and evaluate its predictive value for weaning outcomes.</p> Study design <p>This retrospective study included preterm infants undergoing SBT in a neonatal intensive care unit. Patients were classified as successful or failed weaning based on reintubation or escalation of respiratory support within 48 h. Weight-adjusted RSBI [f/(Vt/kg)] was calculated, and parameters at multiple SBT time points were compared. Receiver operating characteristic analysis assessed predictive performance.</p> Result <p>Eighty-six infants were enrolled (58 successful, 28 failed). Baseline characteristics were comparable. RSBI increased significantly after 30 min in the failed group. At 60 min, RSBI was higher in failed infants (16.31 ± 3.82 vs. 9.79 ± 2.15; <i>P</i> &lt; 0.001). Predictive ability was high (AUC 0.892; sensitivity 85.7%; specificity 82.8%).</p> Conclusion <p>Rising weight-adjusted RSBI during late SBT predicts weaning failure reliably.</p>

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Weight-adjusted rapid shallow breathing index during spontaneous breathing trial in mechanically ventilated preterm infants

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Rongwei Ma,
  • Li Wang,
  • Xiangrong Zhang

摘要

Objective

To characterize dynamic changes in the weight-adjusted rapid shallow breathing index (RSBI) during a 60-min spontaneous breathing trial (SBT) in mechanically ventilated preterm infants and evaluate its predictive value for weaning outcomes.

Study design

This retrospective study included preterm infants undergoing SBT in a neonatal intensive care unit. Patients were classified as successful or failed weaning based on reintubation or escalation of respiratory support within 48 h. Weight-adjusted RSBI [f/(Vt/kg)] was calculated, and parameters at multiple SBT time points were compared. Receiver operating characteristic analysis assessed predictive performance.

Result

Eighty-six infants were enrolled (58 successful, 28 failed). Baseline characteristics were comparable. RSBI increased significantly after 30 min in the failed group. At 60 min, RSBI was higher in failed infants (16.31 ± 3.82 vs. 9.79 ± 2.15; P < 0.001). Predictive ability was high (AUC 0.892; sensitivity 85.7%; specificity 82.8%).

Conclusion

Rising weight-adjusted RSBI during late SBT predicts weaning failure reliably.