Evidence map›Paper›PMID 37889228›Full record

ArticleCritical care medicine2024

Ventilator Weaning and Terminal Extubation: Withdrawal of Life-Sustaining Therapy in Children. Secondary Analysis of the Death One Hour After Terminal Extubation Study.

Charlene P Pringle, Stephanie L Filipp, Wynne E Morrison, Nina A Fainberg, Melissa D Aczon, Michael Avesar, Kimberly F Burkiewicz, Harsha K Chandnani, Stephanie C Hsu, Eugene Laksana and 14 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 12 institutions in 1 country.

Charlene P PringleDepartment of Pediatrics, Critical Care Medicine, University of Florida, Gainesville, FL.
Stephanie L FilippDepartment of Pediatrics, Pediatric Research Hub, University of Florida Gainesville, FL.
Wynne E MorrisonDepartment of Pediatrics, Critical Care Medicine, University of Florida, Gainesville, FL.
Nina A FainbergDivision of Pediatric Critical Care, Children's Hospital of Philadelphia Philadelphia, PA.
Melissa D AczonDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles Los Angeles, CA.
Michael AvesarDivision of Pediatric Critical Care Medicine, Loma Linda University Children's Hospital, Loma Linda, CA.
Kimberly F BurkiewiczPediatric Intensive Care, OSF HealthCare, Children's Hospital of Illinois, Peoria, IL Peoria, IL.
Harsha K ChandnaniDivision of Pediatric Critical Care Medicine, Loma Linda University Children's Hospital, Loma Linda, CA.
Stephanie C HsuDivision of Critical Care Medicine, Department of Pediatrics, Dallas, TX.
Eugene LaksanaDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles Los Angeles, CA.
David R LedbetterKPMG Lighthouse, Dallas, TX.
Michael C McCroryDepartments of Anesthesiology and Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC.
Katie R MorrowAnn & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Anna E NoguchiProgram Coordinator for Organ, Eye, and Tissue Donation Johns Hopkins Hospital, Baltimore, MD.
Caitlin E O'BrienDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
Apoorva OjhaMichigan State University College of Human Medicine, East Lansing, MI.
Patrick A RossDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles Los Angeles, CA.
Sareen ShahLaura P. and Leland K. Whittier Virtual Pediatric Intensive Care Unit, Los Angeles, CA.
Jui K ShahDivision of Pediatric Critical Care Medicine, Loma Linda University Children's Hospital, Loma Linda, CA.
Linda B SiegelDivision of Pediatric Critical Care Medicine, Cohen Children's Medical Center, New Hyde Park, NY.
Sandeep TripathiPediatric Intensive Care, OSF HealthCare, Children's Hospital of Illinois, Peoria, IL Peoria, IL.
Randall C WetzelDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles Los Angeles, CA.
Alice X ZhouDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles Los Angeles, CA.
Meredith C WinterDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles Los Angeles, CA.
Virtual High School · USChildren's Hospital of Illinois · USChildren's Hospital of Los Angeles · USUniversity of Florida Health · USUniversity of Southern California · USChildren's Hospital of Philadelphia · USCohen Children's Medical Center · USJohns Hopkins University · USLighthouse Guild · USLurie Children's Hospital · USMichigan State University · USTexas Neurology · US

Funding

Using social networks to map and evaluate team science across CTSA hubsUL1TR001427 · NCATS · UNIVERSITY OF FLORIDA · PI MITCHELL, DUANE A. · 2015 to 2024
$37.2M
NCATS NIH HHS UL1 TR001427
6 · The paper itself

Abstract

objectiveTerminal 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.

designSecondary analysis of multicenter retrospective cohort study.

settingTen PICUs in the United States between 2009 and 2021. PATIENTS: Nine hundred thirteen patients 0-21 years old who died after WLST.

interventionsNone. MEASUREMENTS AND MAIN

results71.4% ( 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 io2 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).

conclusionsDecreasing 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.

Indexed as

Airway ExtubationVentilator WeaningAdolescentAdultChildChild, PreschoolHumansInfantInfant, NewbornRespiration, ArtificialRetrospective StudiesWithholding TreatmentYoung Adult

Identifiers

PMID37889228
PMCPMC10922051
OpenAlexW4387966811

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.