Palliative Extubation in Critically Ill Patients: A Retrospective Study of Timing, Prior Expressions of…

Cross-sectionalPalliative medicine reports· Jan 2026

Palliative Extubation in Critically Ill Patients: A Retrospective Study of Timing, Prior Expressions of Will, Sedation, and Outcomes.

Rodolfo Moraes Silva, Francielem Guglielmo Vilela, Marília Adler Galvão da Silva … Melissa Perin

Palliative & End-of-LifeCross-sectionalClinical practiceQ1IF 1.4

Most patients who undergo palliative extubation die during the same hospitalization.

Palliative Extubation in Critically Ill Patients: A Retrospective Study of Timing, Prior Expressions of Will, Sedation, and Outcomes.

Rodolfo Moraes Silva … Melissa Perin

Palliative medicine reports · Jan 2026

Purpose

To characterize palliative extubation (palliative extubation) as a clinical and ethical process in critically ill patients in a public hospital in Brazil, focusing on timing of palliative care (palliative care) involvement, shared decision-making, symptom management, and outcomes.

Methods

This retrospective cross-sectional study included adult patients who underwent palliative extubation between January 2022 and December 2024.

n = 447 patients

Results

in-hospital death is the near-universal outcome after palliative extubation

In-hospital mortality

91.8%

Discharged

8.2%

More results

Among 447 patients evaluated by the palliative care team, 122 (27.3%) underwent palliative extubation.

The mean age was 69.7 years, and 51.6% were female.

The mean time from hospital admission to palliative care consultation was 8.3 days.

More results

Opioids were used in 77.0% of patients, predominantly morphine; palliative sedation was required in 21.3%, always with midazolam.

“

Conclusion · 1 of 2

In this cohort, palliative extubation was integrated into a structured, family-centered process involving interdisciplinary consensus and individualized symptom management.

Conclusion · 2 of 2

The variability in survival after extubation supports its interpretation as withdrawal of disproportionate treatment rather than an intervention intended to hasten death, underscoring the importance of early palliative care integration in intensive care settings.

Palliative Extubation in Critically Ill Patients: A Retrospective Study of Timing, Prior Expressions of Will, Sedation, and Outcomes.

Palliative Extubation in Critically Ill Patients: A Retrospective Study of Timing, Prior Expressions of Will, Sedation, and Outcomes.

Related papers