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Use of a Central Venous Line for Fluids, Drugs and Nutrient Administration in a Mouse Model of Critical Illness

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Sex and critical illness.

Robert A Fowler¹, Woganee Filate, Michael Hartleib

¹Department of Medicine, Interdepartmental Division of Critical Care Medicine, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. rob.fowler@sunnybrook.ca

Current Opinion in Critical Care

|August 7, 2009

Summary

Men are more frequently admitted to intensive care units and may receive more aggressive treatment than women. Underlying reasons for these sex differences in critical illness admission and care remain unclear.

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Area of Science:

Critical care medicine
Sex differences in health
Intensive care unit (ICU) outcomes

Background:

Men are more commonly admitted to ICUs than women.
Men may receive more aggressive life support interventions.
Differences in critical illness incidence (e.g., acute lung injury, sepsis) and care provision may contribute.

Purpose of the Study:

To review and speculate on mechanisms behind sex-related differences in critical illness.
To explore sex differences in ICU admission, care delivery, and outcomes.
To examine biological rationales and research inclusion biases.

Main Methods:

Review of evidence from multiple countries on sex differences in ICU care.
Exploration of potential biological mechanisms and animal models.
Analysis of sex-based disparities in clinical research participation.

Main Results:

Men are more frequently admitted to ICUs and may receive more aggressive care.
Confounding factors include differences in critical illness incidence and care provision.
Decision-making by patients, surrogates, and healthcare professionals may be sex-dependent.
Clinical outcome differences are unclear, potentially more pronounced in older patients.

Conclusions:

Sex disparities exist in critical illness incidence and care provision.
The relationship between these disparities, risk factors, and decision-making is not fully understood.
Further research is needed to clarify the impact of sex on critical illness management and outcomes.