The rapid shallow breathing index (RSBI) as a predictor for extubation success in medical and surgical ICU patients: A retrospective cohort study

•Approximately 10–20 % of adult patients fail extubation and require re-intubation within 48 h of extubation. Predictors of successful extubation are needed and this study examined use of the rapid shallow breathing index (RSBI) in ICU patients who underwent a spontaneous breathing trial with ventilatory pressure support.•The RSBI alone demonstrated low diagnostic accuracy in predicting successful extubation for medical and surgical ICU patients.•Cut-off values for the optimal RSBI differ considerably for medical versus surgical ICU patients; using values based on the patient group is recommended.•The RSBI should be used in conjunction with other parameters for predicting readiness for extubation in medical and surgical ICU patients. Endotracheal intubation and mechanical ventilation comprise common life support interventions for patients in intensive care units (ICUs). Premature or delayed extubation increases the risk of morbidity and mortality. Despite following weaning protocols, 10–20 % of patients fail extubation within 48 h. To improve extubation success, predictors such as the rapid shallow breathing index (RSBI–the ratio of respiratory rate to tidal volume) are needed. The current RSBI value (