NCT07144878

Parasternal Intercostal Ultrasound vs RSBI for Weaning Prediction

Ultrasonographic Assessment of Parasternal Intercostal Muscle Thickness Versus Rapid Shallow Breathing Index for Predicting Weaning From Mechanical Ventilation

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 50 (actual)
• Sponsor: Benha University · Academic / Other
• Sex: All
• Age: 18 Years – 80 Years
• Healthy volunteers: Not accepted

Summary

Mechanical ventilation is essential in the management of critically ill patients, but deciding the proper time to wean and extubate remains a significant challenge. Extubation failure is associated with poor outcomes, including prolonged intensive care unit stay, higher risk of complications, and increased mortality. The rapid shallow breathing index (RSBI) is widely used to predict weaning readiness, but its predictive accuracy is limited. Recently, ultrasound evaluation of respiratory muscles, particularly the parasternal intercostal muscle, has been proposed as a promising bedside tool to assess respiratory effort and load. This comparative clinical trial was conducted on adult intensive care unit patients at Benha University Hospital who were mechanically ventilated for ≤24 hours and ready for a spontaneous breathing trial. Each patient underwent both rapid shallow breathing index (RSBI) measurement and parasternal intercostal muscle ultrasound prior to the trial. Patients were classified into successful or failed weaning groups based on trial outcome. The study compared the diagnostic accuracy of both methods and aimed to determine whether ultrasound assessment of the parasternal intercostal muscle offers a more reliable predictor of weaning success than rapid shallow breathing index (RSBI).

Conditions

• Respiratory Insufficiency
• Weaning, Ventilator
• Respiration, Artificial
• Intensive Care Units
• Respiratory Muscles

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	Parasternal Intercostal Ultrasound and RSBI Assessment	Participants underwent ultrasonographic evaluation of the parasternal intercostal muscle using a high-frequency linear probe to measure thickness and the thickening fraction during respiration. In addition, the Rapid Shallow Breathing Index was calculated from ventilator-displayed values under standardized settings: pressure support equal to zero centimeters of water and positive end-expiratory pressure equal to zero centimeters of water. Both assessments were performed immediately prior to a spontaneous breathing trial to evaluate their predictive accuracy for successful weaning from mechanical ventilation.

Timeline

• Start date: 2023-10-03
• Primary completion: 2024-04-01
• Completion: 2024-06-25
• First posted: 2025-08-28
• Last updated: 2025-08-28

Locations

1 site across 1 country: Egypt