The Durban World Congress Ethics Round Table Conference Report: III. Withdrawing Mechanical ventilation-the approach should be individualized

Paruk, Fathima, Kissoon, Niranjan, Hartog, Christiane S., Feldman, Charles, Hodgson, Eric R., Lipman, Jeffrey, Guidet, Bertrand, Du, Bin, Argent, Andrew and Sprung, Charles L. (2014) The Durban World Congress Ethics Round Table Conference Report: III. Withdrawing Mechanical ventilation-the approach should be individualized. Journal of Critical Care, 29 6: 902-907. doi:10.1016/j.jcrc.2014.05.022

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Author Paruk, Fathima
Kissoon, Niranjan
Hartog, Christiane S.
Feldman, Charles
Hodgson, Eric R.
Lipman, Jeffrey
Guidet, Bertrand
Du, Bin
Argent, Andrew
Sprung, Charles L.
Title The Durban World Congress Ethics Round Table Conference Report: III. Withdrawing Mechanical ventilation-the approach should be individualized
Journal name Journal of Critical Care   Check publisher's open access policy
ISSN 0883-9441
1557-8615
Publication date 2014-12-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.jcrc.2014.05.022
Volume 29
Issue 6
Start page 902
End page 907
Total pages 6
Place of publication Maryland Heights, MO United States
Publisher W.B. Saunders
Collection year 2015
Language eng
Formatted abstract
Purpose
The purpose of this study is to determine the approaches used in withdrawing mechanical ventilator support.

Materials and methods
Speakers from the invited faculty of the World Federation of Societies of Intensive and Critical Care Medicine Congress in 2013 with an interest in ethics were asked to provide a detailed description of individual approaches to the process of withdrawal of mechanical ventilation.

Results
Twenty-one participants originating from 13 countries, responded to the questionnaire. Four respondents indicated that they do not practice withdrawal of mechanical ventilation, and another 4 indicated that their approach is highly variable depending on the clinical scenario. Immediate withdrawal of ventilation was practiced by a large number of the respondents (7/16; 44%). A terminal wean was practiced by just more than a third of the respondents (6/16; 38%). Extubation was practiced in more than 70% of instances among most of the respondents (9/17; 53%). Two of the respondents (2/17; 12%) indicated that they would extubate all patients, whereas 14 respondents indicated that they would not extubate all their patients. The emphasis was on tailoring the approach used to suit individual case scenarios.

Conclusions
Withdrawing of ventilator support is not universal. However, even when withdrawing mechanical ventilation is acceptable, the approach to achieve this end point is highly variable and individualized.
Keyword Ethics
Life sustaining treatments
Mechanical ventilation
Withdrawing
Withholding
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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Created: Sun, 14 Dec 2014, 11:30:24 EST by System User on behalf of Anaesthesiology and Critical Care - RBWH