Observational studyIntensive care medicine2017
Terminal weaning or immediate extubation for withdrawing mechanical ventilation in critically ill patients (the ARREVE observational study).
Observational study in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT01818895 (Terminal Weaning of Mechanical Ventilation or Extubation in Anticipation of Death in the Intensive Care Unit), which is not on this map. Cited by 41 papers, 3 of them syntheses 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.
Terminal Weaning of Mechanical Ventilation or Extubation in Anticipation of Death in the Intensive Care Unit: Impact on Relatives, Care Givers and the Dying Process - A Prospective, Multicenter, Observational Study
Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- [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
- European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.Intensive care medicine · 2024Guideline
- Risk factors for complicated grief among family members bereaved in intensive care unit settings: A systematic review.PloS one · 2022Pooled it
- Effectiveness of an Algorithmic Approach to Ventilator Withdrawal at the End of Life: A Stepped Wedge Cluster Randomized Trial.Journal of palliative medicine · 2024Trial
- Withholding and withdrawal of care in the ICU of Eastern France modalities and families feeling.Palliative & supportive care · 2026Observational
- 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
- Review
- Study protocol testing feasibility of the Comfort Measures Only Time out (CMOT) to reduce distress during palliative withdrawal of mechanical ventilation.Pilot and feasibility studies · 2025Article
- Intensive care clinicians' experiences of palliative withdrawal of mechanical ventilation: a qualitative study.BMJ open · 2025Article
- Practice of pediatric palliative extubation in Brazil: a case series.Critical care science · 2025Article
- Care of the Patient Nearing the End of Life in the Neurointensive Care Unit.Neurocritical care · 2024Review
- Process of Withdrawal of Mechanical Ventilation at End of Life in the ICU: Clinician Perceptions.CHEST critical care · 2024Article
- Ventilator Weaning and Terminal Extubation: Withdrawal of Life-Sustaining Therapy in Children. Secondary Analysis of the Death One Hour After Terminal Extubation Study.Critical care medicine · 2024Article
- Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Psychosocial Predictors of Ventilator weaning Outcomes among patients in intensive care units.Heliyon · 2024Article
- Terminal Extubation or Terminal Weaning: Is it Feasible in Indian Intensive Care Units?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Evidence Guiding Withdrawal of Mechanical Ventilation at the End of Life: A Review.Journal of pain and symptom management · 2023Review
- Decision Aids in the ICU: a scoping review.BMJ open · 2023Article
- Temporal reciprocal relationships among anxiety, depression, and posttraumatic stress disorder for family surrogates from intensive care units over their first two bereavement years.BMC psychiatry · 2023Observational
Corrections and comments
- Commented on by
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- Commented on by
- Erratum issued
Authors and funding
49 authors at 20 institutions in 1 country.
Funding
Abstract
purposeThe relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives.
methodsThis prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance. The primary outcome was posttraumatic stress symptoms (Impact of Event Scale Revised, IES-R) in relatives 3 months after the death. Secondary outcomes were complicated grief, anxiety, and depression symptoms in relatives; comfort of patients during the dying process; and job strain in staff.
resultsWe enrolled 212 (85.5%) relatives of 248 patients with terminal weaning and 190 relatives (90.5%) of 210 patients with immediate extubation. Immediate extubation was associated with airway obstruction and a higher mean Behavioural Pain Scale score compared to terminal weaning. In relatives, IES-R scores after 3 months were not significantly different between groups (31.9 ± 18.1 versus 30.5 ± 16.2, respectively; adjusted difference, -1.9; 95% confidence interval, -5.9 to 2.1; p = 0.36); neither were there any differences in complicated grief, anxiety, or depression scores. Assistant nurses had lower job strain scores in the immediate extubation group.
conclusionsCompared to terminal weaning, immediate extubation was not associated with differences in psychological welfare of relatives when each method constituted standard practice in the ICU where it was applied. Patients had more airway obstruction and gasps with immediate extubation.
trial registrationClinicalTrials.gov identifier: NCT01818895.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.