How patients feel about prolonged mechanical ventilation 1 year later

Area of Science:

• Critical Care Medicine
• Patient-Reported Outcomes
• Medical Decision-Making

Background:

• Prolonged mechanical ventilation (MV) is a life-sustaining intervention for critically ill patients.
• Patient preferences regarding MV are crucial for informed decision-making and end-of-life care.
• Understanding factors influencing these preferences is essential for personalized critical care.

Purpose of the Study:

• To determine the preferences of patients who previously underwent prolonged mechanical ventilation regarding this therapy.
• To identify patient characteristics associated with mechanical ventilation preferences.
• To assess how the intensive care unit (ICU) experience influences these preferences.

Main Methods:

• Prospective cohort study involving 133 patients who survived 12 months after prolonged mechanical ventilation (>/=48 hours).
• Patients reflected on their actual MV experiences and evaluated hypothetical scenarios.
• Data collected on patient demographics, health status, and perceived pain, familial financial burden, and stress.

Main Results:

• 86.5% of patients would have chosen mechanical ventilation again.
• Younger and healthier patients were more likely to favor mechanical ventilation.
• Approximately 25% of patients would have refused MV if faced with significant family financial burden or increased pain/discomfort.

Conclusions:

• While most survivors would opt for mechanical ventilation, patient characteristics significantly impact this choice.
• Pain and family financial burden are critical factors that could lead patients to refuse life-sustaining MV.
• These findings highlight the importance of considering patient values and socioeconomic factors in critical care decisions.