2026 Critical Care Congress Skip to main content
2026 Critical Care Congress Main banner
Final Program


Advance Program
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Session Icons
Thought Leader Session
Thought Leader Session
Guidelines Session
Guidelines Session
Aging Adult Track
Aging Adult Track
Additional Registration Fee
Additional Registration Fee

Research Snapshot Theater: Ethics and End of Life, Adult and Pediatric

Palliative Extubation: Institutional Practices and Needs Assessment

Monday, March 23, 2026
2:30 PM - 3:30 PM Central Time
Location: Connections Central - RST 15
  • EW

    Erik Way, MD (he/him/his)

    University of Kansas Health System

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • SG

    Shauna Gibbons, MD

    Palliative Care Physician, Assistant Professor
    University of Kansas Medical Center

    Disclosure information not submitted.

  • AJ

    Amanda Jobe, MD

    Pulmonary/Critical Care Physician, Assistant Professor
    University of Kansas Medical Center

    Disclosure information not submitted.

  • TL

    Tyler Landuyt, MD

    Palliative Care Fellow
    University of Kansas Medical Center

    Disclosure information not submitted.

  • JR

    Jerry Rodgers, MD

    Pulmonary/Critical Care Fellow
    University of Kansas Medical Center

    Disclosure information not submitted.

Introduction: Palliative extubation (PE) describes removal of mechanical ventilation where death is expected and the goal is the patient comfort. As our institution does not implement formal training or protocols for PE, we sought to describe current PE practices in our medical intensive care units (MICU), improve end-of-life care, and identify opportunities to minimize psychological stress through structured surveys of staff members.


Methods: We performed a cross-sectional survey of physicians, advanced practice providers (APPs), nurses (RNs), and respiratory therapists (RTs) at our institution. Quantitative items assessed experience, clinical decision-making, and institutional support. Qualitative responses were analyzed thematically and compared by role.


Results: 55 physicians/APPs and 19 RNs/RTs participated. Over half reported >5 years ICU experience and most had participated in >10 PEs.

This experienced cohort reported comfort during a PE (mean 4.31/5 physician/APP, 4.63/5 RN/RT) and well-controlled patient symptoms >75% of the time (collated 97.3%). Yet, RNs/RTs expressed difficulty in identifying patients at risk for uncontrolled symptoms after PE; physicians/APPs noted challenges in managing complex PEs, including terminal wean and airway collapse.

Among our RN/RT group, many (94.7%) did not regularly reference a formal protocol or receive dedicated training (89.5%), nor did our physician/APP group (72.7% and 54.5% respectively). Use of standardized protocols (collated 75.5%) and subject-specific training (collated 58.5%) were highest scoring among suggested interventions.

Thematic analysis identified key concerns: symptom burden (Physician/APP 58.5%, RN/RT 42.1%); family expectations (58.5%, 63.2%); communication needs (35.8%, 47.4%). RNs/RTs more often emphasized team dynamics and interdisciplinary planning, while physicians/APPs focused on medication management and symptom control.


Conclusions: MICU staff identified breakdowns in communication, inadequate training in identifying and managing complex PEs, high symptom burden, and misalignment with families as contributors to nonoptimal management in PE. Across roles, there was clear need and strong support for institutional protocols and targeted educational initiatives to support patients and team members during PE and end-of-life care.