The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

CRITICAL CARE PRACTITIONERS ATTITUDES TOWARD WITHDRAWAL OF LIFE SUPPORT IN A TERTIARY CARE CENTER

N. T. Bennett1, Anthony J. Asciutto1, Nicole Garrison1, Michael A. Gentile1, Jan J. Thalman1, C. W. Hargett1, Neil MacIntyre1



Background: Withdrawal of life support from patients who require intubation and mechanical ventilation is an issue faced by Critical Care Practitioners of all disciplines. There are different methods of carrying out the process of life support withdrawal and caregivers have variable views of how it should be done. The main issues involve comfort of the patient, family, and health care personnel involved. The purpose of this study was to evaluate Critical Care Practitioners views on the life support withdrawal process.

Methods: A five (5) question survey was distributed to 104 Critical Care Practitioners in our institution. These questions focused on the management of the endotracheal tube, the need for physician attendance and the sedation strategy. Data were also collected for respondents profession and years of experience.

Results: Responses were received from 31 respiratory therapists, 52 nurses, and 22 physicians (total = 104). Ninety five percent responded that endotracheal tubes should be removed as part of the process of withdrawal of life support; 25% felt supplemental O2 should be given (75% felt room air breathing was more appropriate); 67% felt family should be asked to step outside the room during the process; 23% felt that the physician should be in the room; and 68% favored changing the pre-extubation analgesia regimen to include morphine (32% felt the pre-extubation regimen should be maintained).

Conclusion: Opinions vary among Critical Care Practitioners as to the consistent method of withdrawal of mechanical ventilatory support. However, maximizing patient and family comfort during the process seemed to drive most responses.