How is life support withdrawn in intensive care units: A narrative review

Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit

“…3,4 Withdrawal of life-sustaining measures is the most common event preceding death in critical care and there remains considerable variability in WLSM practices. [5][6][7] In an attempt to address this variability, the Canadian Critical Care Society (CCCS) published a guideline for the WLSM in 2016. 8 As with many guidelines, without appropriate knowledge translation tools, implementation of the guideline will be slow with variable uptake.…”

“…Participants were provided with a comprehensive background package including a literature review 7 with a supplementary update along with the CCCS WLSM guideline, 8 the Canadian DCD guideline, 2 and The Donation Physician Ethics Guide. 13 An environmental survey of Canadian critical care units and organ donation organizations was also provided, including existing WLSM checklists, policies, order sets, education materials, flow sheets, and family information booklets.…”

Withholding and withdrawal of life-sustaining treatments in intensive care units in Lebanon: a cross-sectional survey of intensivists and interviews of professional societies, legal and religious leaders

“…The associated ethical issues and emotional burden for the patients, their families and the medical ICU staff, encourages the regular evaluation of these decisions' process, in our personal and institutional medical practice [7][8][9][10]. Scientific societies over the world have endorsed guidelines and promoted recommendations to implement these concepts in the ICU [2,4,7,[11][12][13][14][15]. In some countries, they are even controlled by laws [13,16,17].…”

“…In some countries, they are even controlled by laws [13,16,17]. Clinical studies have been published, especially from North America [11,18,19] and Europe [2,7,16,17,[20][21][22][23][24][25][26] describing and assessing those practices. However, there are very few from Middle Eastern Arabic countries, where ethical values, medical resources, and financial limitations are different from those in Western countries, and where the religious and socio-cultural influences have a major impact [10,[27][28][29][30].…”

Incidence and Risk Model Development for Severe Tachypnea Following Terminal Extubation

“…10,[35][36][37] Unfortunately, there are few data to guide the clinical approach to minimizing respiratory distress during PVW. Although evidence suggests lower rates of respiratory distress with gradual reduction of ventilator support (terminal weaning) vs immediate extubation, 33 it is unknown whether administering analgesia/sedation pre-extubation (anticipatory dosing) 38,39 relieves distress more effectively than giving these drugs only in response to observed symptoms. 40,41 Assessing physical discomfort among patients undergoing PVW is challenging.…”