Ventilator Weaning and Terminal Extubation: Withdrawal of Life-Sustaining Therapy in Children. Secondary Analysis of the Death One Hour After Terminal Extubation Study Article Swipe
Charlene Pringle
,
Stephanie L. Filipp
,
Wynne Morrison
,
Nina Fainberg
,
Melissa Aczon
,
Michael Avesar
,
Kimberly Burkiewicz
,
Harsha Chandnani
,
Stephanie Hsu
,
Eugene Laksana
,
David Ledbetter
,
Michael C. McCrory
,
Katie R. Morrow
,
Anna Noguchi
,
Caitlin E. O’Brien
,
Apoorva Ojha
,
Patrick A. Ross
,
Sareen Shah
,
Jui Shah
,
Linda Siegel
,
Sandeep Tripathi
,
Randall C. Wetzel
,
Alice X. Zhou
,
Meredith C. Winter
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/ccm.0000000000006101
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/ccm.0000000000006101
OBJECTIVE: Terminal extubation (TE) and terminal weaning (TW) during withdrawal of life-sustaining therapies (WLSTs) have been described and defined in adults. The recent Death One Hour After Terminal Extubation study aimed to validate a model developed to predict whether a child would die within 1 hour after discontinuation of mechanical ventilation for WLST. Although TW has not been described in children, pre-extubation weaning has been known to occur before WLST, though to what extent is unknown. In this preplanned secondary analysis, we aim to describe/define TE and pre-extubation weaning (PW) in children and compare characteristics of patients who had ventilatory support decreased before WLST with those who did not. DESIGN: Secondary analysis of multicenter retrospective cohort study. SETTING: Ten PICUs in the United States between 2009 and 2021. PATIENTS: Nine hundred thirteen patients 0–21 years old who died after WLST. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: 71.4% ( n = 652) had TE without decrease in ventilatory support in the 6 hours prior. TE without decrease in ventilatory support in the 6 hours prior = 71.4% ( n = 652) of our sample. Clinically relevant decrease in ventilatory support before WLST = 11% ( n = 100), and 17.6% ( n = 161) had likely incidental decrease in ventilatory support before WLST. Relevant ventilator parameters decreased were F io 2 and/or ventilator set rates. There were no significant differences in any of the other evaluated patient characteristics between groups (weight, body mass index, unit type, primary diagnostic category, presence of coma, time to death after WLST, analgosedative requirements, postextubation respiratory support modality). CONCLUSIONS: Decreasing ventilatory support before WLST with extubation in children does occur. This practice was not associated with significant differences in palliative analgosedation doses or time to death after extubation.
Related Topics
Concepts
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/ccm.0000000000006101
- OA Status
- green
- Cited By
- 2
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4387966811
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4387966811Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1097/ccm.0000000000006101Digital Object Identifier
- Title
-
Ventilator Weaning and Terminal Extubation: Withdrawal of Life-Sustaining Therapy in Children. Secondary Analysis of the Death One Hour After Terminal Extubation StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-10-27Full publication date if available
- Authors
-
Charlene Pringle, Stephanie L. Filipp, Wynne Morrison, Nina Fainberg, Melissa Aczon, Michael Avesar, Kimberly Burkiewicz, Harsha Chandnani, Stephanie Hsu, Eugene Laksana, David Ledbetter, Michael C. McCrory, Katie R. Morrow, Anna Noguchi, Caitlin E. O’Brien, Apoorva Ojha, Patrick A. Ross, Sareen Shah, Jui Shah, Linda Siegel, Sandeep Tripathi, Randall C. Wetzel, Alice X. Zhou, Meredith C. WinterList of authors in order
- Landing page
-
https://doi.org/10.1097/ccm.0000000000006101Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://pmc.ncbi.nlm.nih.gov/articles/PMC10922051/pdf/nihms-1936014.pdfDirect OA link when available
- Concepts
-
Medicine, Weaning, Anesthesia, Ventilator weaning, Mechanical ventilation, Terminal (telecommunication), Intensive care medicine, Internal medicine, Computer science, TelecommunicationsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
2Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 2Per-year citation counts (last 5 years)
- References (count)
-
26Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.DESIGN: | 109 |
| abstract_inverted_index.adults. | 20 |
| abstract_inverted_index.between | 124, 237 |
| abstract_inverted_index.compare | 93 |
| abstract_inverted_index.defined | 18 |
| abstract_inverted_index.hundred | 130 |
| abstract_inverted_index.patient | 235 |
| abstract_inverted_index.predict | 37 |
| abstract_inverted_index.primary | 245 |
| abstract_inverted_index.sample. | 182 |
| abstract_inverted_index.support | 100, 157, 168, 188, 209, 260, 265 |
| abstract_inverted_index.weaning | 6, 62, 88 |
| abstract_inverted_index.whether | 38 |
| abstract_inverted_index.without | 153, 164 |
| abstract_inverted_index.(weight, | 239 |
| abstract_inverted_index.Although | 53 |
| abstract_inverted_index.RESULTS: | 145 |
| abstract_inverted_index.Relevant | 212 |
| abstract_inverted_index.SETTING: | 117 |
| abstract_inverted_index.Terminal | 1, 27 |
| abstract_inverted_index.analysis | 111 |
| abstract_inverted_index.children | 91, 271 |
| abstract_inverted_index.decrease | 154, 165, 185, 206 |
| abstract_inverted_index.patients | 96, 132 |
| abstract_inverted_index.practice | 275 |
| abstract_inverted_index.presence | 248 |
| abstract_inverted_index.relevant | 184 |
| abstract_inverted_index.terminal | 5 |
| abstract_inverted_index.thirteen | 131 |
| abstract_inverted_index.unknown. | 75 |
| abstract_inverted_index.validate | 32 |
| abstract_inverted_index.PATIENTS: | 128 |
| abstract_inverted_index.Secondary | 110 |
| abstract_inverted_index.analysis, | 80 |
| abstract_inverted_index.category, | 247 |
| abstract_inverted_index.children, | 60 |
| abstract_inverted_index.decreased | 101, 215 |
| abstract_inverted_index.described | 16, 58 |
| abstract_inverted_index.developed | 35 |
| abstract_inverted_index.evaluated | 234 |
| abstract_inverted_index.secondary | 79 |
| abstract_inverted_index.therapies | 12 |
| abstract_inverted_index.Clinically | 183 |
| abstract_inverted_index.Decreasing | 263 |
| abstract_inverted_index.Extubation | 28 |
| abstract_inverted_index.OBJECTIVE: | 0 |
| abstract_inverted_index.associated | 278 |
| abstract_inverted_index.diagnostic | 246 |
| abstract_inverted_index.extubation | 2, 269 |
| abstract_inverted_index.incidental | 205 |
| abstract_inverted_index.mechanical | 49 |
| abstract_inverted_index.modality). | 261 |
| abstract_inverted_index.palliative | 283 |
| abstract_inverted_index.parameters | 214 |
| abstract_inverted_index.preplanned | 78 |
| abstract_inverted_index.ventilator | 213, 221 |
| abstract_inverted_index.withdrawal | 9 |
| abstract_inverted_index.differences | 228, 281 |
| abstract_inverted_index.extubation. | 291 |
| abstract_inverted_index.multicenter | 113 |
| abstract_inverted_index.respiratory | 259 |
| abstract_inverted_index.significant | 227, 280 |
| abstract_inverted_index.ventilation | 50 |
| abstract_inverted_index.ventilatory | 99, 156, 167, 187, 208, 264 |
| abstract_inverted_index.CONCLUSIONS: | 262 |
| abstract_inverted_index.MEASUREMENTS | 142 |
| abstract_inverted_index.requirements, | 257 |
| abstract_inverted_index.retrospective | 114 |
| abstract_inverted_index.INTERVENTIONS: | 140 |
| abstract_inverted_index.analgosedation | 284 |
| abstract_inverted_index.analgosedative | 256 |
| abstract_inverted_index.postextubation | 258 |
| abstract_inverted_index.pre-extubation | 61, 87 |
| abstract_inverted_index.characteristics | 94, 236 |
| abstract_inverted_index.describe/define | 84 |
| abstract_inverted_index.discontinuation | 47 |
| abstract_inverted_index.life-sustaining | 11 |
| cited_by_percentile_year.max | 97 |
| cited_by_percentile_year.min | 95 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 24 |
| citation_normalized_percentile.value | 0.83640915 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |