Evidence map›Paper›PMID 40780709›Full record

ArticleBMJ open2025

Intensive care clinicians' experiences of palliative withdrawal of mechanical ventilation: a qualitative study.

Nikolaos Efstathiou, Fotini Kristina Michaela Diridis, Michelle Orr, Marianne Baernholdt, Brandi Vanderspank-Wright

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

5 authors.

Nikolaos EfstathiouDepartment of Nursing and Midwifery, University of Birmingham, Birmingham, UK n.efstathiou@bham.ac.uk.ORCID http://orcid.org/0000-0001-5811-8982
Fotini Kristina Michaela DiridisIntensive Care Medicine and Anaesthesia, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Michelle OrrWright Center for Clinical and Translational Research, VCU Health, Richmond, Virginia, USA.
Marianne BaernholdtUniversity of Virginia, Charlottesville, Virginia, USA.
Brandi Vanderspank-WrightSchool of Nursing, University of Ottawa, Ottawa, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore intensive care unit (ICU) clinicians' experiences of withdrawing mechanical ventilation during end-of-life care.

designAn exploratory qualitative design was used, with data collected via semistructured, face-to-face online interviews and analysed using reflexive thematic analysis.

participantsWe recruited ICU clinicians from two hospitals within the West Midlands region of the UK. DATA COLLECTION: Semistructured, face-to-face online interviews were used to explore experiences with limitation of life-sustaining treatments in ICU, decision-making and practices for withdrawing mechanical ventilation.

findings22 ICU clinicians were interviewed (Physiotherapist=1, Advanced Critical Care Practitioners=4, Physicians=9 and Nurses=8), of which 13 were women (59%). Four themes were developed. (1) Multilayered communication: effective communication was key in planning withdrawal and informing family members, with conflicts arising from cultural differences. (2) Considerations regarding the mode of withdrawing invasive mechanical ventilation: clinicians expressed differing preferences for the method of mechanical ventilation withdrawal. (3) Multiprofessional teamwork: collaborative teamwork was vital, with palliative care practitioners consulted during conflicts or challenging symptoms. (4) Clinicians' feelings and impact: clinicians empathised with families and experienced psychological burden.

conclusionsPhysician preferences influence the withdrawal process, which is communicated within the multidisciplinary team. Clear protocols can help reduce ambiguity and support less experienced clinicians. Reflection on these practices may help mitigate burnout and compassion fatigue. Further research should examine the effects of physician demographics and patient cultural diversity on the withdrawal process.

Indexed as

Attitude of Health PersonnelCritical CarePalliative CareRespiration, ArtificialTerminal CareWithholding TreatmentAdultCommunicationDecision MakingFemaleHumansIntensive Care UnitsInterviews as TopicMaleMiddle AgedQualitative ResearchAdult intensive & critical careAdult palliative careQUALITATIVE RESEARCH

Identifiers

PMID40780709
PMCPMC12336532

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.