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Terminal Weaning and Terminal Extubation within the Context of End-of-Life Care in the Intensive Care Unit: A Quantitative Descriptive Analysis of Recent PracticesAl-Janabi, Mustafa 13 October 2021 (has links)
Background: The withdrawal of invasive mechanical ventilation (MV) within the context of withdrawal of life-sustaining measures (WLSM) is common in the intensive care unit (ICU). The method by which invasive MV is withdrawn during WLSM remains an ongoing topic of discussion and research; two methods are terminal weaning (TW) and terminal extubation (TE).
Aims: To statistically describe and compare the processes of TW and TE as undertaken in two ICUs.
Study Design: A secondary data analysis using data from a longitudinal retrospective chart audit.
Results: A total of 78 patient charts were included. MV was withdrawn in 88.5% of patients undergoing WLSM. TW was used in 62.3% of the cases while TE was used in 37.7%. Patients who underwent TW were on average younger, had a longer ICU stay, higher respiratory support requirements, a longer duration of invasive MV, and shorter period from first change in MV parameters to patient death.
Conclusion: This study highlights the nuances and complexities within MV withdrawal and WLSM in the ICU.
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