Observational studyJournal of palliative medicine2015
Time to Death after Terminal Withdrawal of Mechanical Ventilation: Specific Respiratory and Physiologic Parameters May Inform Physician Predictions.
Observational study in Journal of palliative medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [Treatment and support for adults at the end of life in intensive care. A recommendation by the Ethics Section of DIVI and the German Society for Palliative Medicine. : Part 2: Therapeutic measures and support at the end of life in intensive care].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Effectiveness of an Algorithmic Approach to Ventilator Withdrawal at the End of Life: A Stepped Wedge Cluster Randomized Trial.Journal of palliative medicine · 2024Trial
- Palliative extubation in intensive care units: scoping review.Revista da Escola de Enfermagem da U S P · 2026Article
- Withdrawal of Mechanical Ventilation in the Intensive Care Unit: A Prospective Observational Study.CHEST critical care · 2025Article
- How Long Do We Have? A Retrospective Review of Palliative Extubation in the Burn Unit.Journal of burn care & research : official publication of the American Burn Association · 2025Article
- Review
- Evidence Guiding Withdrawal of Mechanical Ventilation at the End of Life: A Review.Journal of pain and symptom management · 2023Review
- Prediction of survival time after terminal extubation: the balance between critical care unit utilization and hospice medicine in the COVID-19 pandemic era.European journal of medical research · 2023Article
- Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Children.Critical care explorations · 2022Review
- End-of-Life and Palliative Care in a Critical Care Setting: The Crucial Role of the Critical Care Pharmacist.Pharmacy (Basel, Switzerland) · 2022Article
- Predicting Time to Death After Withdrawal of Life-Sustaining Measures Using Vital Sign Variability: Derivation and Validation.Critical care explorations · 2022Article
- Emotional impact of compassionate extubation on respiratory therapists and nurses: A pilot study.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2022Article
- Predictors of withdrawal of life support after burn injury.Burns : journal of the International Society for Burn Injuries · 2019Article
- Focus on palliative care in the ICU.Intensive care medicine · 2017Article
- ICU physicians' and nurses' perceptions of terminal extubation and terminal weaning: a self-questionnaire study.Intensive care medicine · 2016Article
- Mechanical ventilation withdrawal as a palliative procedure in a Brazilian intensive care unit.Revista Brasileira de terapia intensivaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiscussions about withdrawal of life-sustaining therapies often include family members of critically ill patients. These conversations should address essential components of the dying process, including expected time to death after withdrawal.
objectivesThe study objective was to aid physician communication about the dying process by identifying predictors of time to death after terminal withdrawal of mechanical ventilation.
methodsWe conducted an observational analysis from a single-center, before-after evaluation of an intervention to improve palliative care. We studied 330 patients who died after terminal withdrawal of mechanical ventilation. Predictors included patient demographics, laboratory, respiratory, and physiologic variables, and medication use.
resultsThe median time to death for the entire cohort was 0.58 hours (interquartile range (IQR) 0.22-2.25 hours) after withdrawal of mechanical ventilation. Using Cox regression, independent predictors of shorter time to death included higher positive end-expiratory pressure (per 1 cm H2O hazard ratio [HR], 1.07; 95% CI 1.04-1.11); higher static pressure (per 1 cm H2O HR, 1.03; 95% CI 1.01-1.04); extubation prior to death (HR, 1.41; 95% CI 1.06-1.86); and presence of diabetes (HR, 1.75; 95% CI 1.25-2.44). Higher noninvasive mean arterial pressure predicted longer time to death (per 1 mmHg HR, 0.98; 95% CI 0.97-0.99).
conclusionsComorbid illness and key respiratory and physiologic parameters may inform physician predictions of time to death after withdrawal of mechanical ventilation. An understanding of the predictors of time to death may facilitate discussions with family members of dying patients and improve communication about end-of-life care.
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