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Medline ® Abstract for Reference 80

of 'Palliative care: Issues in the intensive care unit in adults'

Withdrawal of mechanical ventilation in the home: a case report and review of the literature.
Clinch A, Le B
Palliat Med. 2011 Jun;25(4):378-81. Epub 2011 Jan 19.
Once it has been determined that aggressive medical treatment can no longer meet the goals of care for a ventilated patient, the process of withdrawing mechanical ventilation begins. This is a challenging clinical situation, drawing on the treating physician's skills including clinical decision making with consideration of the ethical and legal domains of practice, high level communication skills, intensive symptom control for the dying patient, and support for families throughout the episode, including bereavement. Central to the success of this process is recognition and respect for the needs and wishes of the patient and family. This case reports on the withdrawal of mechanical ventilation from a conscious patient in their own home, leading to death, following a prolonged hospital admission.
Department of Palliative Care, Royal Melbourne Hospital, Grattan St, Parkville, Victoria 3050, Australia. Alexandra.Clinch@mh.org.au