Weaning of invasive mechanical ventilation in a critical coronary care unit

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. A critical moment when using IMV is the weaning of the IMV. Objective Our aim is to describe which factors may have an influence on the success or the failure of the weaning of IMV. Methods Observational, retrospective study, using a cohort of patients admitted to a CCCU between January 2.018 and November 2.020 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 94 patients were included, being 68 (72,3%) male and with a mean age of 68 years old. The most frequent reason of intubation was cardiac arrest (48 patients – 51,1%). Failure on weaning occurred in 19 patients (20,2%), being the most frequent reason of this failure need of re-intubation due to respiratory failure or a new event of cardiac arrest (14 patients – 14,9%). When assessing which factors could have an impact in this failure, we found that older age (66,6 years old vs. 73,9 years old, p value = 0,035), the previous diagnosis of chronic obstructive pulmonary disease (COPD) (17,1% vs. 28,5%, p value = 0,01), and the develop of sepsis during the hospitalization (45,7% vs. 57%, p value =0,04), determined a significative higher probability of failing in the weaning. As expected, failure in the weaning conditioned a significative longer stay in the CCCU (9 days vs. 22 days; p value Conclusion In our population, the older age, the presence of COPD and the development of sepsis during the stay in the CCCU were related with a significative higher probability of failure in the weaning of IMV. This conditioned a longer stay in the CCCU but not a higher intra-hospitalary mortality.