Abstract
Some mechanically ventilated cancer patients will not be restored to a desirable baseline function after a trial of critical care. Decisions with these patients and/or their surrogates may be made to withdraw mechanical ventilation (MV) and allow a natural, comfortable death. Withdrawal of MV leads to patient suffering and distress and to high levels of psychological distress among family members if not performed correctly [1]. The focus of this chapter is the process of withdrawing MV to ensure patient respiratory comfort.
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Appendix: Respiratory Distress Observation Scale ©
Appendix: Respiratory Distress Observation Scale ©
Variable | 0 points | 1 point | 2 points | Total |
|---|---|---|---|---|
Heart rate per minute | <90 beats | 90–109 beats | ≥110 beats |  |
Respiratory rate per minute | ≤18 breaths | 19–30 breaths | >30 breaths |  |
Restlessness: non-purposeful movements | None | Occasional, slight movements | Frequent movements | Â |
Accessory muscle use: rise in clavicle during inspiration | None | Slight rise | Pronounced rise | Â |
Paradoxical breathing pattern | None | Â | Present | Â |
Grunting at end-expiration: guttural sound | None | Â | Present | Â |
Nasal fearing: involuntary movement of nares | None | Â | Present | Â |
Look of fear | None | Â | Eyes wide open, facial muscles tense, brow furrowed, mouth open | Â |
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Campbell, M.L. (2018). Ventilator Withdrawal at the End of Life. In: Esquinas, A., Pravinkumar, S., SOUBANI, A. (eds) Mechanical Ventilation in Critically Ill Cancer Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-49256-8_29
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DOI: https://doi.org/10.1007/978-3-319-49256-8_29
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