<s>[INST] My brother has been on a vent for 2 months. They have tried weaning to no success. He has cirrhosis . He is awake and alert. He is no shape to be able to receive compressions for CPR . What happens if he is off the vent (trach collar and his heart is still beating but his breathing stops. Do they just put him back on the vent? and hwo does with work with a CPR DNR advance directive? [/INST] Hi and welcome to Chat Doctor.DNR directive must be approved by patient or his closest family if patient is unconscious or unaware of his condition. This is evaluated by neurologist and psychiatrist. When they put him off vent they try to see is he able to breathe independently. If not, he is put back on the vent immediately. Every time this is risky manipulation and patient can pass away;he must be put on vent in 20-30 seconds. If he is awake then his condition might improve and there is no reason to force extubation. CPR can always be done, with more or less success. I don't get why compressions depends on his shape. Regards. </s>