Terminal Weaning of Mechanical Ventilation or Extubation in Anticipation of Death in the Intensive Care Unit

Centre Hospitalier Departemental Vendee458 enrolled

Overview

The purpose of the study is to assess the dying process in critically ill patients with decision to withdraw invasive mechanical ventilation in anticipation of death and to compare effects of extubation and those of terminal weaning of mechanical ventilation on relatives and care givers. The investigators primary hypothesis is that extubation is associated with less symptoms of post-traumatic stress disorders in relatives, as compared to terminal weaning.

Study Type

OBSERVATIONAL

Enrollment

458

Conditions

Withdrawal Anxiety Depression Posttraumatic Stress Disorder

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * End of life decision to withdraw invasive mechanical ventilation after at least 48 hours of ICU stay Exclusion Criteria: * Age under 18 years * Non invasive mechanical ventilation * Brain death * Death before withdrawal of mechanical ventilation * No French-speaking relative * Refusal of relative to participate the study

Locations (44)

Réanimation médicale CHU

Angers, France

Réanimation, CH d'Angoulême

Angoulême, France

Réanimation, CH d'Annecy

Annecy, France

Réanimation

Belfort, France

CHU Pellegrin Tripode

Bordeaux, France

Réanimation, CHU

Bordeaux, France

CHU Ambroise Paré

Boulogne, France

CHU La Cavale Blanche

Brest, France

CHU de Côte de Lumière

Caen, France

Centre Hospitalier, Service de réanimation

Charleville-Mézières, France

...and 34 more locations

Outcomes

Primary Outcomes

Post traumatic Stress Disorder

Post traumatic Stress Disorder as assessed by the Impact of event Scale-revised(IES-R)

Time frame: three month after patient's death

Secondary Outcomes

Post traumatic Stress Disorder

Post traumatic stress disorder of relatives assessed by the Impact of Event Scale -revised (IES-R)

Time frame: 12 months after patient's death

Anxiety and depression

Anxiety and depression of the relatives, assessed by the hospital Anxiety and Depression Scale (HADS)

Time frame: 3, 6 and 12 months after patient's death

Complicated grief

Complicated grief as assessed by the Inventory of Complicated Grief (ICG) scale

Time frame: 6 and 12 months after patient's death

Relative's satisfaction

Questionnaire on relative's satisfaction

Time frame: 3 months after patient's death

Nurse's satisfaction

Questionnaire on nurse's satisfaction

Time frame: within day 1 after patient's death

Physician's satisfaction

Questionnaire on physician's satisfaction

Time frame: within day 1 after patient's death

Burn out syndrome of the nurse

Burn out syndrome of the patient's nurse as assessed by the Job Strain scale

Time frame: within day 1 after patient's death

Burn out syndrome of the physician

Burn out syndrome of the patient's physician as assessed by the Job Strain scale

Time frame: within day 1 after patient's death