The Durban World Congress Ethics

208 words) PURPOSE To determine the approaches used in withdrawing mechanical ventilator support. MATERIALS and METHODS Speakers 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. RESULTS Twenty 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 is practiced by just over a third of the respondents [6/16; 38%]. Extubation is practiced in more than 70% of instances amongst the majority of the respondents [(9/17; 53%]. Two of the respondents [2/17; 12%] indicated that they would extubate all patients whilst 14 respondents indicated that they would not extubate all their patients. The emphasis was on tailoring the approach utilised to suit individual case scenarios. CONCLUSIONS Withdrawing of ventilator support is not universal. However, even when withdrawing mechanical ventilation is acceptable, the approach to achieve this endpoint is highly variable and individualised. AC C EP TE D M AN U SC R IP T ACCEPTED MANUSCRIPT