Q: After terminal discontinuation of ventilator support in patients destined for comfort care (withdrawal of care), all of the following effect the time to death except?

A) Number of organs not working
B) Vasopressor on board
C) Volume status
D) Surgical versus medical patient
E) Length of time on ventilator prior to extubation


Answer: E

As per study published in chest (2010), looking over 1500 patients, the median time to death after withdrawal of ventilator support was 0.9 hours. The major factors effecting the time to death included all of the above (Choices A, B, C and D) except the length of the time spent on ventilator prior to extubation.


Reference: 

Cooke CR, Hotchkin DL, Engelberg RA, et al. Predictors of time to death after terminal withdrawal of mechanical ventilation in the ICU. Chest 2010; 138:289.