Invasive mechanical ventilation in the coronary unit, does the sex matters?

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In the recent years, we have assisted to a change of the prototype of the patient admitted to a Critical Coronary Care Unit (CCCU), with an increasing number of patients admitted due to acute heart failure (AHF) and the reduction of the patients diagnosed of acute coronary syndrome (ACS). It is common in these patients the requirement of ventilatory support, both invasive (IMV) and non-invasive. As a consequence, our knowledge about this technique must be improved. Furthermore, we frequently observe differences in the profile and the prognosis of the patients according to their sex. Objective Our aim is to describe the differences according to the sex in patients treated with IMV. Methods Observational, retrospective study, using a cohort of patients admitted to a CCCU between January 2.018 and April 2.021 who needed IMV. Data related with the personal history, basal situation and events in the follow-up during the hospitalization were collected. Results A total number of 140 patients were included, being 103 (73,6%) male and with a mean age of 67 years old. In the Abstract Picture 1, we show the most interesting characteristics of the population (previous history, complications during the hospitalization and in-hospital mortality). The most frequent cause of intubation was cardiac arrest (CA) with a 47,9% of the cases (67 patients). Mean stay in the CCCU was 12 days, with a median of 8 days. Only 8 patients (5,7%) needed the performation of a tracheostomy and 53 (37,9%) died during the hospitalization. When comparing sex (Picture 1), we did not find any significative differences according to age of the patients, the cause of their admission (Picture 2) or their previous history but the presence of Chronic Obstructive Pulmonary Disease (COPD), which was significatively more frequent in male (21 vs 2, p = 0,035). There were no differences in the cause of the hospitalization, the intra-hospitalary mortality or the main complications during this hospitalization (shock, sepsis, needing of renal sustitutive therapy). Conclusion In our population of patients admitted to a CCCU who require IMV, we can affirm that we find a very homogeneous population when refering to the sex of the patients admitted, not finding any significative differences according to the personal history and prognosis, only COPD being more frequent in male, which can be relevant as these patients may need to be ventilated in a different way.