However, about one third of patients who meet these criteria cannot be weaned successfully. A patient breathing spontaneously when the ventilator is set not to deliver any additional pressure other than what the patient generates is on a CPAP of zero. Patients who do not wean successfully may be considered for transfer to a long-term care facility that accepts ventilated patients. Some patients choose not to spend their last days in the hospital and prefer to die at home or in a nursing home. Supportive care can be arranged in both settings.
Hospice care is an option in either setting.
Families and caregivers should be taught how to treat worsening distress and what to do when death comes. When a patient has made a decision to have mechanical ventilation withdrawn, the physician should ensure the patient's comfort during this process. Comfort measures may include the use of drugs to relieve pain or dyspnea, even though such use may hasten death. All rights reserved.