Purpose: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance.
Secondary outcomes were complicated grief, anxiety, and depression symptoms in relatives; comfort of patients during the dying process; and job strain in staff. Results: We enrolled Immediate extubation was associated with airway obstruction and a higher mean Behavioural Pain Scale score compared to terminal weaning.
In relatives, IES-R scores after 3 months were not significantly different between groups Assistant nurses had lower job strain scores in the immediate extubation group. Conclusions: Compared to terminal weaning, immediate extubation was not associated with differences in psychological welfare of relatives when each method constituted standard practice in the ICU where it was applied.
Patients had more airway obstruction and gasps with immediate extubation. Trial registration: ClinicalTrials. Keywords: Critical care; Ethics; Immediate extubation; Mechanical ventilation; Terminal weaning; Treatment limitation.
Abstract Purpose: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives.
