• Stéphane Delisle, Martin Francoeur, Martin Albert, Paul Ouellet, Patrick Bellemare, and Pierre Arsenault.
• Respiratory Therapy Department, Hôpital du Sacré-Coeur, Montréal, Québec, Canada. sdelisle@hotmail.com
• Resp Care. 2011 Oct 1;56(10):1500-5.

BackgroundThe available predictors of spontaneous-breathing-trial (SBT) success/failure lack accuracy. We devised a new index, the CORE index (compliance, oxygenation, respiration, and effort).ObjectiveTo compare the CORE index to the CROP index (compliance, rate, oxygenation, and pressure), airway-occlusion pressure 0.1 s after the start of inspiratory flow (P(0.1)), and rapid shallow breathing index (RSBI) for predicting SBT success/failure in a critical care environment.MethodsWith 47 mechanically ventilated patients recovering from respiratory failure, of various causes, we prospectively examined the SBT success/failure prediction accuracy and calculated receiver operating characteristic curves, sensitivity, specificity, and likelihood ratios of CORE, CROP, P(0.1), and RSBI.ResultsThe specificities were CORE 0.95, P(0.1) 0.70, CROP 0.70, and RSBI 0.65. The sensitivities were CORE 1.00, CROP 1.00, P(0.1) 0.93, and RSBI 0.89. The areas under the receiver operating characteristic curve were CORE 1.00 (95% CI 0.92-1.00), CROP 0.91 (95% CI 0.79-0.97), P(0.1) 0.81 (95% CI 0.67-0.91), and RSBI 0.77 (95% CI 0.62-0.88). The positive likelihood ratios were CORE 20.0, CROP 3.3, P(0.1) 3.1, and RSBI 2.5. The negative likelihood ratios were CORE 0.0, CROP 0.0, P(0.1) 0.1, and RSBI 0.2.ConclusionsThe CORE index was the most accurate predictor of SBT success/failure.

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