Terminal Weaning and Terminal Extubation within the Context of End-of-Life Care in the Intensive Care Unit: A Quantitative Descriptive Analysis of Recent Practices
Bibliographic record
Abstract
Background: The withdrawal of invasive mechanical ventilation (MV) within the context of withdrawal of life-sustaining measures (WLSM) is common in the intensive care unit (ICU). The method by which invasive MV is withdrawn during WLSM remains an ongoing topic of discussion and research; two methods are terminal weaning (TW) and terminal extubation (TE). Aims: To statistically describe and compare the processes of TW and TE as undertaken in two ICUs. Study Design: A secondary data analysis using data from a longitudinal retrospective chart audit. Results: A total of 78 patient charts were included. MV was withdrawn in 88.5% of patients undergoing WLSM. TW was used in 62.3% of the cases while TE was used in 37.7%. Patients who underwent TW were on average younger, had a longer ICU stay, higher respiratory support requirements, a longer duration of invasive MV, and shorter period from first change in MV parameters to patient death. Conclusion: This study highlights the nuances and complexities within MV withdrawal and WLSM in the ICU.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".