TABLE 8.

Transition from active treatment to end-of-life care for prolonged mechanical ventilation or long-term mechanical ventilation

Criteria that should define transition	%
Patient exhibiting prolonged suffering (physical, mental, emotional, spiritual)	100
Patient’s advance directives/previous expressed wishes based on informed choice	100
Informed consent to proceed from patient or appropriate designate	100
Treatment goal changed to palliation/comfort care	97
Family/surrogate decision maker wishes based on informed choice	97
Best anticipated functional outcome no longer being acceptable to the patient	97
Quality of life	95
Patient, family and health care team agreement on plan for end-of-life care	95
Patient values (cultural/religious/moral)	92
Current accepted professional and ethical standards	92
Illness that is irreversible and/or nontreatable	87
Ability to medically manage end-of-life process in resource-appropriate manner	84
Physiological end points	82
An appropriate environment	82
Multisystem organ failure	82
Availability of team with specialized palliative care support	79
Health care team agreement	71
Criteria that should NOT define transition
Patient’s physical location	95
Age	87
Time on ventilatory support	84
Level of physical dependency	79