Respiratory medicine · 2025
Clinical characteristics and outcomes of patients undergoing palliative extubation.
СтатьяНазвание и аннотация: Перевод в очереди
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Krinsley James S, Walker Katherine H, Zerihun Lilian, Ilyas Farwa, Ehinmisan Ayara, Ketenci Melis, Preiser Jean-Charles
Аннотация
PURPOSE: To characterize clinical features and outcomes of patients undergoing palliative extubation (PalExt) from mechanical ventilation (MV) and to compare these to those patients who died during MV (DMV).
METHODS: This is a single-center study including all patients undergoing MV in the Stamford Hospital ICU between 4/1/16 and 3/14/2020 and 10/1/2021 and 3/31/23, excluding those admitted during the first and second waves of Covid-19. Data were abstracted from the intensive care unit's (ICU) databases and the hospital's electronic medical record.
RESULTS: A total of 1911 patients underwent MV during the study period, including 226 PalExt and 177 DMV. Compared to DMV, PalExt were older, less likely to be functionally independent and more likely to be admitted with a cardiac or neurologic diagnosis. 84.5 % of PalExt were admitted to the ICU with "full code" resuscitation status and the median time to comfort care orders was 2 days. 77.0 % died in the ICU and 98.7 % died before hospital discharge. The median duration from PalExt to death in the ICU was 118 min. Patients receiving consultations from the Palliative Care service had significantly longer ICU length of stay and days of MV.
CONCLUSIONS: This investigation documents significant differences between patients undergoing PalExt and those who die while undergoing MV.
METHODS: This is a single-center study including all patients undergoing MV in the Stamford Hospital ICU between 4/1/16 and 3/14/2020 and 10/1/2021 and 3/31/23, excluding those admitted during the first and second waves of Covid-19. Data were abstracted from the intensive care unit's (ICU) databases and the hospital's electronic medical record.
RESULTS: A total of 1911 patients underwent MV during the study period, including 226 PalExt and 177 DMV. Compared to DMV, PalExt were older, less likely to be functionally independent and more likely to be admitted with a cardiac or neurologic diagnosis. 84.5 % of PalExt were admitted to the ICU with "full code" resuscitation status and the median time to comfort care orders was 2 days. 77.0 % died in the ICU and 98.7 % died before hospital discharge. The median duration from PalExt to death in the ICU was 118 min. Patients receiving consultations from the Palliative Care service had significantly longer ICU length of stay and days of MV.
CONCLUSIONS: This investigation documents significant differences between patients undergoing PalExt and those who die while undergoing MV.