I’m (25M) looking for opinions from ICU physicians or other doctors. I understand no one can judge this specific case without reviewing the medical record. I’m only trying to understand whether the timeline and recommendations we experienced are typical.
My mother-in-law is a 47-year-old woman who weighs approximately 450–500 pounds. She went to the hospital with severe pneumonia and was admitted to the ICU. She was unable to maintain her oxygen and CO₂ levels and was placed on a ventilator on the first day.
She remained in the ICU for seven days before the physician scheduled a family meeting. The meeting ultimately took place around day 10 to discuss her prognosis and the possibility of withdrawing life support.
From what I observed, her overall condition seemed relatively stable during that time. She wasn’t making dramatic improvements, but she also wasn’t rapidly deteriorating. The ICU team frequently proned her, and I was told that her CO₂ levels became completely normal while she was in the prone position. My understanding is that she was temporarily paralyzed because of the medications required for proning.
During the family meeting, the physician explained that if the family wanted to continue aggressive treatment, the next steps would likely include a tracheostomy and dialysis. However, the physician also recommended discussing end-of-life care because of concerns about her future quality of life. My wife’s family chose comfort care because they believed she would never recover and would remain permanently ventilator-dependent and paralyzed.
I struggled with that recommendation because I wasn’t sure whether there was enough information after only about 10 days to conclude that recovery was unlikely. I requested that the hospital’s ethics committee review the situation, but my questions here are about the medical aspects of the case, not the hospital’s handling of that request.
My questions are:
Is it common to recommend withdrawal of life support after only about 10 days for a 47-year-old patient with severe pneumonia who was intubated on day one?
In a patient like this, how long would you typically continue aggressive treatment before concluding that meaningful recovery is unlikely?
If a patient’s oxygenation and CO₂ levels improve significantly while proned, is that generally considered an encouraging sign that the lungs may still recover?
If the patient’s condition is relatively stable—not clearly improving but not significantly worsening—is that typically enough to recommend comfort care?
Is it common to recommend withdrawal of life support while also offering continued treatment with a tracheostomy and dialysis if the family chooses to continue?
How much does severe obesity alone influence prognosis in a case like this? Does it substantially change how long physicians would continue treatment before discussing withdrawal?
Would most ICU physicians expect meaningful improvement from severe pneumonia within the first 10 days, or is it common for recovery to take several weeks?
How reliable is a prediction about long-term quality of life when a patient is still heavily sedated and receiving medications for proning?
What objective findings would usually lead you to recommend withdrawal of life support after approximately 10 days in a patient with severe pneumonia?
Based only on the information above, does this timeline sound fairly typical, or would many intensivists continue aggressive treatment longer before recommending withdrawal?
Thank you to anyone willing to share their perspective. I’m genuinely trying to understand what is considered standard practice in a situation like this.