61 - Tobin index

Q: Which of the following is the best test to predict succesful extubation of a patient ?

a. Respiratory rate
b. Negative inspiratory pressure
c. Minute ventilation
d. Tobin index

Answer : D

*Unfortunately there is still no truly reliable way of predicting which patient will be succesfully extubated after a weaning program, and the decision for extubation is based on a combination of clinical parameters and measured pulmonary mechanics.

*The TOBIN INDEX  (Frequency : Tidal volume ratio), also known as the RAPID SHALLOW BREATHING INDEX (RSBI), is perhaps the best negative predictive instrument when performed as Yang and Tobin originally described.

*If the result is less than 105, then there is nearly a 70% chance the patient will pass extubation.

*If the score is greater than 105, the patient has an approximately 80% chance of failing extubation.