Women are less likely to receive lung protective tidal volumes when being considered as a lung donor

A study presented at the CHEST Annual Meeting 2018 in San Antonio examined the adherence to lung protective ventilation and whether there were sex specific differences in mechanical ventilation strategies. The authors found that potential organ donors frequently did not receive appropriate low tidal volumes (VT) in the transplant evaluation period.

More than half (65 percent) of all patients received excessive VT during the 48 hours prior to death. In addition, 40 percent of the time patients received excessively high volumes. Women were more likely to receive excessively high tidal volumes than men (76 percent of women vs 57 percent of men; P<.001). Women also spent more time receiving excessive VT (46 percent of the time vs 32 percent of the time for men) and were more likely to receive TVs greater than 10mL/kg.

The association between female sex and excessive VT remained significant after multiple regression analysis adjusting for height, BMI, trauma death and donation outcomes. Other independent predictors of excessive TVs were morbid obesity, shorter height and trauma as a cause of death.

"While this is a single-center retrospective review, it suggests the possibility of an important disparity," states lead researcher Dr. Joaquin A. Chapa. "Multicenter studies are needed to determine the impact of excessive tidal volumes on organ suitability and outcomes."