• Fathima Paruk, Niranjan Kissoon, Christiane S Hartog, Charles Feldman, Eric R Hodgson, Jeffrey Lipman, Bertrand Guidet, Bin Du, Andrew Argent, and Charles L Sprung.
• Department of Anaesthesiology and Division of Critical Care, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: Fathima.Paruk@wits.ac.za.
• J Crit Care. 2014 Dec 1;29(6):902-7.

PurposeThe purpose of this study is to determine the approaches used in withdrawing mechanical ventilator support.Materials And MethodsSpeakers from the invited faculty of the World Federation of Societies of Intensive and Critical Care Medicine Congress in 2013 with an interest in ethics were asked to provide a detailed description of individual approaches to the process of withdrawal of mechanical ventilation.ResultsTwenty-one participants originating from 13 countries, responded to the questionnaire. Four respondents indicated that they do not practice withdrawal of mechanical ventilation, and another 4 indicated that their approach is highly variable depending on the clinical scenario. Immediate withdrawal of ventilation was practiced by a large number of the respondents (7/16; 44%). A terminal wean was practiced by just more than a third of the respondents (6/16; 38%). Extubation was practiced in more than 70% of instances among most of the respondents (9/17; 53%). Two of the respondents (2/17; 12%) indicated that they would extubate all patients, whereas 14 respondents indicated that they would not extubate all their patients. The emphasis was on tailoring the approach used to suit individual case scenarios.ConclusionsWithdrawing of ventilator support is not universal. However, even when withdrawing mechanical ventilation is acceptable, the approach to achieve this end point is highly variable and individualized.Copyright © 2014 Elsevier Inc. All rights reserved.

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