anaesthesia critical-care respiratory

RSBI (Rapid Shallow Breathing Index) — Weaning Readiness

Rapid Shallow Breathing Index (f/Vt) predicts successful extubation. RSBI <105 associated with successful weaning. Used with SBT and clinical readiness assessment.

Score interpretation

Weaning Success Likely 0–79.99

RSBI < 80 breaths/min/L — strong predictor of weaning success.

→ Extubate when RSBI <105 + passed SBT; have re-intubation equipment ready; consider high-flow nasal cannula (HFNC) post-extubation prophylactically; CPAP for obstructive physiology

Borderline — Reassess 80–105

RSBI 80–105 — borderline; weaning success possible.

→ Repeat SBT after 24h if failed; address reversible causes (fluid overload, secretions, pain, weakness); consider tracheostomy if >14 days ventilation likely; wean PEEP and FiO2 progressively

Weaning Failure Likely ≥ 105.01

RSBI > 105 — rapid shallow breathing predicts weaning failure (Yang & Tobin 1991).

→ Continue mechanical ventilation; treat underlying cause; weaning protocol reassessment daily; physiotherapy (inspiratory muscle training); optimise nutrition; ICU team review; tracheostomy consideration

Interpretation bands for the RSBI Ventilator Weaning. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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