Percepción de los médicos acerca de extubación paliativa en las unidades de cuidado intensivo

Introduction: During patients' stay in the Intensive Care Unit (ICU), the attending physicians may be faced with the need to withdraw life support, such as mechanical ventilatory support. Objective: To evaluate the physicians' perception regarding palliative extubation and the factors that influence their decision making in the ICU in Colombia. Methodology: A self-applied survey was conducted among 36 physicians from different medical disciplines. Sociodemographic aspects, ethical, legal perceptions, and the influence of spirituality in the discontinuation of mechanical ventilation were analyzed. Results: The majority of participants were male ICU physicians with less than five years of intensive care experience. In terms of clinical decision-making, 92% of the participants considered that the limitation or withdrawal of therapies was a key component of medical practice in the ICU, and that it should be applied regardless of underlying medical condition. Concerning mechanical ventilation withdrawal technique, the majority (50%) chose terminal weaning, while a smaller percentage (5.6%) viewed terminal extubation as an illegal practice. This study also found that religiosity and spirituality played a relevant role in medical decision making. Conclusions: Quantitative results showed substantial variability in physician perception of palliative extubation, in particular according to specialty and religious beliefs.