{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:01:55Z","timestamp":1791378115224,"version":"4.3.2"},"reference-count":25,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Palliative ventilator withdrawal (PVW) involves removal of mechanical ventilation in patients not expected to survive to allow a peaceful death. This process traditionally occurs in Intensive Care Units (ICU) and recently has evolved to occur in Inpatient Hospice and Palliative Care Units (IPU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the process and response of patients undergoing PVW in an IPU setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a longitudinal observational cohort study of adult patients who underwent PVW in an IPU from January 2021 through March 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 25 enrolled subjects, median age was 68 (IQR 62.5-76.5) years and 14 (56%) were females. Median time from PVW to death was 16.8 (IQR 2.6-100) hours. A registered nurse and attending physician were present in all the cases, while a respiratory therapist was present in 20 (80%) and chaplain in 9 (36%) of the cases. Before PVW, opioids and benzodiazepines were administered to 24 (96%) patients. Post PVW, respiratory distress was noted among 16 (64%) patients and medication was given to 15 (60%) patients for respiratory distress. There was a significant association between the presence of respiratory distress and administration of medication within 30\u00a0minutes after PVW ( P = .009). The rituals performed during PVW were reciting prayers for 11 (44%), playing music for 8 (32%), and observing silence for 6 (24%) of the patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study describes the PVW practices in an IPU setting where a multidisciplinary team was present during PVW for most of the cases and two-third of the patients undergoing PVW experienced respiratory distress immediately after PVW.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091221129827","type":"journal-article","created":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T05:15:21Z","timestamp":1663996521000},"page":"720-726","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Palliative Ventilator Withdrawal Practices in an Inpatient Hospice Unit"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-6459","authenticated-orcid":false,"given":"Ramandeep","family":"Kaur","sequence":"first","affiliation":[{"name":"Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Harmon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Palliative Medicine, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6714-2669","authenticated-orcid":false,"given":"Augustin","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Palliative Medicine, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyembezi L","family":"Dhliwayo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Palliative Medicine, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Palliative Medicine, Rush University Medical Center, Chicago, IL, USA"},{"name":"Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Palliative Medicine, Rush University Medical Center, Chicago, IL, USA"},{"name":"Department of Internal Medicine, Division of Pulmonary and Critical Care, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,24]]},"reference":[{"key":"bibr1-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2017.05.004"},{"key":"bibr2-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1177\/0269216309346540"},{"key":"bibr3-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1016\/s0885-3924(03)00333-6"},{"key":"bibr4-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.4.9801108"},{"key":"bibr5-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030083"},{"key":"bibr6-10499091221129827","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc1996.5.5.331"},{"key":"bibr7-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.04.027"},{"key":"bibr8-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0142"},{"key":"bibr9-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0289"},{"key":"bibr10-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.52.8.1602"},{"key":"bibr11-10499091221129827","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.21.2732"},{"issue":"1196","key":"bibr12-10499091221129827","first-page":"U935","volume":"117","author":"Mann 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