Palliative extubation in intensive care units: scoping review.

OBJECTIVE

To map existing knowledge on palliative extubation in adult patients admitted to intensive care units.

METHOD: Scoping review conducted according to JBI guidelines. Searches were conducted between October and December 2024 in seven databases and four repositories, in addition to a reverse search. The selection was independent, the extraction followed a structured protocol, and the report used PRISMA-ScR. The analysis of the results was based on the PAGER framework (Patterns, Advances, Gaps, Evidence for practice and Research recommendations).

RESULTS

The search identified 1,463 materials and included 44 studies. Publications in 2023 predominated. The findings addressed recommendations for practice, time to death, comparison between terminal extubation and terminal weaning, symptom management, experiences and challenges of professionals, as well as aspects related to decision-making and the use of protocols in palliative extubation.

CONCLUSION

Palliative extubation remains marked by heterogeneous practices and limited production of high-level evidence. There is a need for evidence-based protocols and multidisciplinary training to ensure quality care, dignity, and relief from suffering at the end of life.