<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-3347</journal-id>
<journal-title><![CDATA[Colombian Journal of Anestesiology]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. colomb. anestesiol.]]></abbrev-journal-title>
<issn>0120-3347</issn>
<publisher>
<publisher-name><![CDATA[SCARE-Sociedad Colombiana de Anestesiología y Reanimación]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-33472021000400008</article-id>
<article-id pub-id-type="doi">10.5554/22562087.e986</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Palliative extubation: obstacles, challenges and solutions]]></article-title>
<article-title xml:lang="es"><![CDATA[Extubación paliativa: obstáculos, desafíos y soluciones]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amaya-Vanegas]]></surname>
<given-names><![CDATA[Sandra Viviana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gomezese-Ribero]]></surname>
<given-names><![CDATA[Ómar Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Industrial de Santander Anesthesiology and Resuscitation ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fundación Cardiovascular de Colombia Pain Clinic ]]></institution>
<addr-line><![CDATA[ Floridablanca]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>49</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-33472021000400008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-33472021000400008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-33472021000400008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Life support withdrawal can be a challenging decision, but it should be considered as an option when death is inevitable or recovery to an acceptable quality of life is not possible. The process is beset by obstacles that must be overcome to finally offer patients comfort and a peaceful death. In this article, we offer a series of tools that seek to solve the challenges of palliative extubation, as well as a protocol that could facilitate the decision to withdraw life support, making palliative extubation an alternative to consider instead of artificially prolonging life at the expense of unacceptable human and economic costs.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La interrupción de la asistencia vital puede ser una decisión complicada, aun cuando se debe considerar como una opción cuando la muerte es inevitable o la recuperación a una calidad de vida aceptable no es posible. A lo largo del proceso se encuentran obstáculos que se deben sortear para finalmente ofrecer a los pacientes una muerte tranquila y confortable. En este artículo ofrecemos una serie de herramientas que buscan solucionar los desafíos de la extubación paliativa y presentamos una guía de extubación que podría facilitar la decisión de retiro del soporte vital, haciendo de la extubación paliativa una alternativa por considerar en lugar de prolongar la vida de manera artificial a expensas de un costo humano y económico inaceptable.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Palliative care]]></kwd>
<kwd lng="en"><![CDATA[Hospice care]]></kwd>
<kwd lng="en"><![CDATA[Airway extubation]]></kwd>
<kwd lng="en"><![CDATA[Life support care]]></kwd>
<kwd lng="en"><![CDATA[Right to die]]></kwd>
<kwd lng="es"><![CDATA[Cuidados paliativos]]></kwd>
<kwd lng="es"><![CDATA[Cuidados paliativos al final de la vida]]></kwd>
<kwd lng="es"><![CDATA[Extubación traqueal]]></kwd>
<kwd lng="es"><![CDATA[Cuidados para prolongación de la vida]]></kwd>
<kwd lng="es"><![CDATA[Derecho a morir]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gracia]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Álvarez-Lerma]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Botet]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<source><![CDATA[Predicción de mortalidad del paciente ingresado en UCI: desarrollo y validación de un nuevo modelo pronóstico]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Autónoma de Barcelona]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Billings]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Humane terminal extubation reconsidered: The role for preemptive analgesia and sedation]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2012</year>
<volume>40</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>625-30</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Calvache]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Gil]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[de Vries]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How many people need palliative care for cancer and non-cancer diseases in a middle-income country?]]></article-title>
<source><![CDATA[Analysis of mortality data. Colombian Journal of Anesthesiology]]></source>
<year>2020</year>
<volume>48</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McVeigh]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Eldakar-Hein]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Terminal extubation]]></article-title>
<source><![CDATA[Hosp Med Clin]]></source>
<year>2015</year>
<volume>4</volume>
<page-range>272-81</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reta]]></surname>
<given-names><![CDATA[IS]]></given-names>
</name>
<name>
<surname><![CDATA[Diarasarri]]></surname>
<given-names><![CDATA[SI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recomendaciones de tratamiento al final de la vida del paciente crítico]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2008</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>121-33</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chan]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Treece]]></surname>
<given-names><![CDATA[PD]]></given-names>
</name>
<name>
<surname><![CDATA[Engelberg]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Narcotic and benzodiazepine use after withdrawal of life support: association with time to death?]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2004</year>
<volume>126</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>286-93</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marr]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Weissman]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Withdrawal of ventilatory support from the dying adult patient]]></article-title>
<source><![CDATA[J Support Oncol]]></source>
<year>2004</year>
<volume>2</volume>
<page-range>283-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Curtis]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Practical guidance for evidence-based ICU family conferences]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2008</year>
<volume>134</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>835-43</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
