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Updated: Jan 19, 2026
A Structured Approach to Extubation in Mechanically Ventilated Rats
Published on: July 18, 2025
Palliative extubation: five-year experience in a pediatric hospital
Carolina de Araújo Affonseca1, Luís Fernando Andrade de Carvalho2, Renata de Pinho Barroso Quinet2
1Hospital Infantil João Paulo II, Unidade CUIDAR - Cuidado Paliativo e Atenção Domiciliar, Belo Horizonte, MG, Brazil.
Insights
Palliative extubation in children with chronic diseases is complex. Specialized multidisciplinary care is essential for symptom management and support during ventilatory withdrawal.
Area of Science:
- Pediatric critical care medicine
- Palliative care
- Respiratory medicine
Background:
- Chronic and irreversible diseases in children often necessitate long-term mechanical ventilation.
- Palliative extubation is a procedure for children with terminal conditions to withdraw ventilatory support.
Purpose of the Study:
- To characterize pediatric patients undergoing palliative extubation.
- To describe patient demographics, diagnoses, and outcomes.
Main Methods:
- Descriptive analysis of 19 pediatric patients.
- Data collected from medical records (April 2014 - May 2019).
- Included demographics, ventilation details, extubation specifics, medications, symptoms, and outcomes.
Main Results:
- Mean age 2.2 years; 57.9% died in-hospital.
- Extubations primarily in the ICU (68.4%).
- Common symptoms: dyspnea and pain, managed with opioids and benzodiazepines.
Conclusions:
- No predictors of in-hospital death were identified.
- Palliative extubation necessitates specialized, multidisciplinary team care.
- Adequate training in symptom control and palliative care is crucial.
Objective:
To present the characteristics of pediatric patients with chronic and irreversible diseases submitted to palliative extubation.
Method:
This is a descriptive analysis of a series of patients admitted to a public pediatric hospital, with chronic and irreversible diseases, permanently dependent on ventilatory support, who underwent palliative extubation between April 2014 and May 2019. The following information was collected from the medical records: demographic data, diagnosis, duration and type of mechanical ventilation; date, time, and place of palliative extubation; medications used; symptoms observed; and hospital outcome.
Results:
A total of 19 patients with a mean age of 2.2 years were submitted to palliative extubation. 68.4% of extubations were performed in the ICU; 11 patients (57.9%) died in the hospital. The time between mechanical ventilation withdrawal and in-hospital death ranged from 15minutes to five days. Thirteen patients used an orotracheal tube and the others used tracheostomy. The main symptoms were dyspnea and pain, and the main drugs used to control symptoms were opioids and benzodiazepines.
Conclusions:
It was not possible to identify predictors of in-hospital death after ventilatory support withdrawal. Palliative extubation requires specialized care, with the presence and availability of a multidisciplinary team with adequate training in symptom control and palliative care.
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