Our Experience with Terminal Weaning from Ventilatory Support in Critical Care Patients

Overview

Terminal weaning from ventilatory support represents on of the possible techniques of complex withdrawing of therapy in patients with irreversiblefailure of vital functions. In the period from January 1, 1999 to June 1, 2000 mechanical ventilation was withdrawn in 15 patients with terminal illnesses;all patients from the group died. In ten patients, withdrawing of ventilatory support was done by terminal disconnection from the ventilator, in fivepatients ventilatory support was gradually decreased without terminal extubation. Analgosedation was used in eight patients, no muscle relaxants wereused. The mean period of ventilatory support withdrawal until the pronounciation of death was 243 minutes. The detailed information on ventilatorysupport withdrawal as a part of the process of organ functions supporting measures withdrawal was given to the family in five cases. Ventilatorysupport withdrawal is medically accepted management in appropriate cases. This is in accordance with ethical principles of current practice ofmedicine, as well as with current legislation on health care provision.

Key words:
intensive care – mechanical ventilation – weaning from ventilatory support – ethical principles – legislation