The study is designed to develop an empirically powered, nurse-led approach to patient comfort during the ventilator withdrawal process, reducing patient suffering and family members distress. Half a million individuals undergo ventilator withdrawal each year Nearly, but there is little empirical evidence to inform this common procedure. With no accepted evidence-based guidelines guiding ventilator withdrawal, clinicians depend on intuition, varying levels of experience or customary regional practice. The researchers will compare outcomes for individuals who received a fresh method of patients who received typical care. Data from this research will be used to steer additional screening of the algorithm in another randomized trial.Hormone-receptor status was evaluated by using immunohistochemical analysis for progesterone and estrogen receptors and the semiquantitative 8-point score produced by Allred et al.16 Tumors were regarded as positive for the expression of hormone receptor if they were positive for either estrogen receptor or progesterone receptor. HER2 protein expression was scored centrally according to the guidelines for HER2 staining17 . Fluorescence in situ hybridization for HER2 was performed for all cells samples with a score of 2+ or higher. Assessment for the expression of HER2 and chromosome 17 was performed, and the ratio of HER2 to chromosome 17 signaling was set up for scoring.2.17 The ultimate score for every tumor sample was the mean rating for two cores from each specimen.