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Requested withdrawal of mechanical ventilation in six patients with motor neuron disease

Lookup NU author(s): Dr Tom Payne-Doris, Dr Timothy Williams

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Abstract

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. Objectives: Mechanical ventilation (MV) has been shown to improve survival and quality of life in motor neuron disease (MND). However, during the progression of MND, there may come a point when MV is no longer felt appropriate. Association of Palliative Medicine Guidelines have been recently published to help clinicians withdraw MV at the request of patients with MND in a safe and compassionate manner to ensure that symptoms of distress and dyspnoea are minimised. Methods: In this report, we discuss the palliative and ventilatory management of six ventilator-dependent patients with MND who had requested the withdrawal of MV as part of their end-of-life care. Results: We have withdrawn MV from six patients with MND at their request and our practice has been influenced by the Association of Palliative Medicine Guidelines. Conclusion: Withdrawal of MV in MND at a patient's request is challenging but is also a fundamental responsibility of healthcare teams. We discuss the lessons we have learnt which will influence our practice and help other teams in the future.

Publication metadata

Author(s): Messer B, Armstrong A, Doris T, Williams T

Publication type: Article

Publication status: Published

Journal: BMJ Supportive and Palliative Care

Year: 2020

Volume: 10

Issue: 1

Pages: 10-13

Print publication date: 19/02/2020

Online publication date: 03/04/2019

Acceptance date: 06/03/2019

ISSN (print): 2045-435X

ISSN (electronic): 2045-4368

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/bmjspcare-2017-001464

DOI: 10.1136/bmjspcare-2017-001464

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