An Observational Study to Assess the Correlation between Rapid Shallow Breathing Index and Handgrip Strength in Weaning Patients from Mechanical Ventilation | Chapter 8 | Medical Science: Trends and Innovations Vol. 6

Background: Weaning patients from mechanical ventilation is a crucial part of ICU care. There are various indices and criteria to help with the same. We chose to explore the significance of HGS – Hand grip strength and RSBI – Rapid shallow breathing index. RSBI is a well-established tool to assess the patient’s progress before going in for the Spontaneous Breathing Trial - SBT. HGS on the other hand is another tool to check and ascertain the strength of the respiratory muscles.

Aim: The aim of the study was to evaluate the correlation that could exist between HGS and RSBI in order to go ahead with weaning from mechanical ventilation. This was our primary objective. The secondary objective was to recognize the difference in HGS between the groups of successful weaning and failed weaning and also to find the differences in HGS between the groups of simple weaning, difficult weaning and prolonged weaning.

Methods: In this prospective study, patients who fulfilled the criteria of being ready to be weaned off mechanical ventilation, underwent a Spontaneous Breathing Trail - SBT. During the preliminary SBT, data such as vital signs, RSBI, type of SBT, time of SBT success, and time of extubation were also collected. HGS was assessed using a Jamar dynamometer in kilograms. HGS was tested at 48 hours post intubation 10 minutes prior to SBT and 30 minutes post SBT. In addition, this measurement was also further tested 1 hour after extubation. RSBI and HGS tests were both tested 10 minutes before the SBT.

Results: Thirty-seven mechanically ventilated patients were included in this study and all these patients were also included in the final analysis. There were 24(64.86%) males. The mean age was found to be 55.32±15.58 years. APACHE II score was found to be 14.108± 5.26. Majority of the patients were intubated due to pneumonia (5%, 2 of 37 patients). The most widely used SBT in our study was pressure support ventilation (95%, 35 of 37 patients). The highest HGS was demonstrated at 1 hour post-extubation (14.14± 0.65Kg). RSBI tested 10 minutes before SBT was found to be 54.89± 9.85 breaths/min/L.

Conclusion:

Ø  This study has helped us arrive at the conclusion that HGS and RSBI seem to have a positive correlation in ICU patients who were weaned from mechanical ventilation.

Ø  RSBI is a main indicator for successful weaning.

 

Author (s) Details

Swetha Ramani Chinnappan Kuppusamy
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Saranya Babu
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Chandhinie Ramesh
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Pushparani Anand
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Mirunalini Gunaseelan
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Karthik Kandan
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v6/4216

Recent Study to Evaluate the Intervention being Provided by AWCs Regarding Breastfeeding, Weaning and Child Diet in District Budgam of Kashmir Region (J&K) (Based on Beneficiary Responses) | Chapter 10 | Current Strategies in Economics and Management Vol. 1

This study was undertaken to evaluate a response regarding the intervention being provided by Integrated Child Development Services (ICDS) in District Budgam. The study was conducted in 60 Anganwadi Centers (AWCs) and the beneficiaries included three registered groups viz., Pregnant Women (PW), Nursing Mothers (NM), and mothers of child beneficiaries (MCB) having children in the age group 0-3 years - 4 beneficiaries were selected from each AWC. Since India’s 66% of the total population comprises of mother and children who are also the foremost patrons of health services hence they are the “priority,” “special risk” and “vulnerable group.” and therefore explicit programmes for augmenting maternal and child health have been in place since the early fifties in India. These AWCs serve the purpose and are assumed to provide pre-school education on one hand and breaking vicious cycle of malnutrition, morbidity and mortality on the other hand. By instructing women beneficiaries and also providing supplementary nutrition. Keeping in view the above aspects and also to evaluate the intervention being provided by Anganwadi centers this study was planned and designed accordingly. Results obtained indicate that inadequate intervention is being provided regarding most of the aspects of breastfeeding with 86% denying the intervention regarding initiation of breastfeeding and 96% said no awareness regarding frequency of breastfeeding is provided in AWCs and 97% reporting no intervention regarding importance of balanced diet for children, although some of the blocks are better in providing information regarding some aspects while as others are lacking the ability to improve the knowledge of their beneficiaries regarding various parameters  under study, which needs to be further taken care of through, advanced interventions by involving Anganwadi centres and medical department for the safety and health of our children. All the results were obtained by using Chi-square analysis and by comparing the responses of beneficiaries and AWWs (Anganwadi workers) across the blocks.

Author(s) Details

Dr. Iffat Jabeen Ghani
Krishi Vigyan Kendra (KVK), SKUAST-K, Pulwama, Kashmir, India.

View Book: - http://bp.bookpi.org/index.php/bpi/catalog/book/174