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BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access December 29, 2014

Surgical tracheotomy performed with and without dual antiplatelet therapy

  • Andrej Markota , Andreja Sinkovič and Bogdan Čizmarević
From the journal Open Medicine

Abstract

Some patients who need dual antiplatelet therapy sometimes require tracheotomy. Aim of this study was to compare the rate of complications during and after surgical tracheotomy between patients requiring dual antiplatelet therapy and those without dual antiplatelet therapy. We retrospectively included 79 patients (62% men, mean age 64 ± 14 years) in the period 2007- 2011. The following complications were analyzed: need for surgical revision within 24 hours after tracheotomy, need for bronchoscopy within 24 hour after tracheotomy, need for blood transfusion within 24 hours after tracheotomy, death attributed to tracheotomy and any complication attributed to tracheotomy. We compared patients where tracheotomy was performed while receiving dual antiplatelet therapy (n=27, 34%) to patients where tracheotomy was performed without dual antiplatelet therapy (n=52, 66%). Nonsignificant differences between the two groups were observed general characteristics. There were no statistically significant differences in complications after tracheotomy (surgical revision after tracheotomy p=0.63, bronchoscopy after tracheotomy p=0.74, blood transfusion after tracheotomy p=0.59, death attributed to tracheotomy p=1.00 and any complication attributed to tracheotomy p=1.00). The study shows that tracheotomy is safe in cardiac patients on dual antiplatelet therapy.

References

[1] Hsu C.L., Chen K.Y., Chang C.H., Jerng J.S., Yu C.J., Yang P.C., Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study, Crit. Care., 2005; 9: R46-5 10.1186/cc3018Search in Google Scholar PubMed PubMed Central

[2] Heffner J.E., Miller K.S., Sahn S.A., Tracheostomy in the intensive care unit. Part 1: Indications, technique, management, Chest, 1986; 90: 269-274 Search in Google Scholar

[3] Combes A., Luyt C.E., Nieszkowska A., Trouillet J.L., Gibert C., Chastre J., Is tracheostomy associated with better outcomes for patients requiring long-term mechanical ventilation?, Crit. Care. Med., 2007; 35: 802-807 Search in Google Scholar

[4] Heffner J.E., Medical indications for tracheotomy, Chest, 1989; 96: 186-190 Search in Google Scholar

[5] Upadhyay A., Maurer J., Turner J., Tiszenkel H., Rosengart T., Elective bedside tracheostomy in the intensive care unit, J. Am. Coll. Surg., 1996; 183: 51-55 Search in Google Scholar

[6] Korte W., Cattaneo M., Chassot P.G., Eichinger S., von Heymann C., Hofmann N. et al., Peri-operative management of antiplatelet therapy in patients with coronary artery disease: joint position paper by members of the working group on Perioperative Haemostasis of the Society on Thrombosis and Haemostasis Research (GTH), the working group on Perioperative Coagulation of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care (ÖGARI) and the Working Group Thrombosis of the European Society for Cardiology (ESC), Thromb. Haemost., 2011; 105: 743-749, doi: 10.1160/TH10-04-0217 10.1160/TH10-04-0217Search in Google Scholar PubMed

[7] Fitchett D., Eikelboom J., Fremes S., Mazer D., Singh S., Bittira B. et al., Dual antiplatelet therapy in patients requiring urgent coronary artery bypass grafting surgery: a position statement of the Canadian Cardiovascular Society, Can. J. Cardiol., 2009; 25: 683-689 Search in Google Scholar

[8] Voigt I., Naber C., Bleeding complications of percutaneous dilatation tracheostomy (PDT) in a group of ICU patients with dual antiplatelet therapy, Crit. Care. Shock, 2012; 15: 70-76 Search in Google Scholar

[9] Sharma S.C., Singh V.K., Anand A., Rao B.K., Percutaneous tracheostomy in patients with coagulopathy, In: J.D. Chiche (Ed.), Abstract of the 23rd ESICM Annual Congress, 2010: 163 Search in Google Scholar

[10] Beiderlinden M., Eikermann M., Lehmann N., Adamzik M., Peters J., Risk factors associated with bleeding during and after percutaneous dilational tracheostomy, Anaesthesia, 2007; 62: 342-346 Search in Google Scholar

[11] Kluge S., Meyer A., Kühnelt P., Baumann H.J., Kreymann G., Percutaneous tracheostomy is safe in patients with severe thrombocytopenia, Chest, 2004; 126: 547-551 Search in Google Scholar

[12] Auzinger G., O’Callaghan G.P., Bernal W., Sizer E., Wendon J.A., Percutaneous Tracheostomy in patients with severe liver disease and a high incidence of refractory coagulopathy: a prospective trial, Crit. Care., 2007; 11: R110 10.1186/cc6143Search in Google Scholar PubMed PubMed Central

[13] Blankenship D.R., Kulbersh B.D., Gourin C.G., Blanchard A.R., Terris D.J., High-risk tracheostomy: exploring the limits of the percutaneous tracheostomy, Laryngoscope, 2005; 115: 987-989 Search in Google Scholar

[14] Blot F., Nitenberg G., Guiguet M., Casetta M., Antoun S., Pico J.L. et al., Safety of tracheotomy in neutropenic patients: a retrospective study of 26 consecutive cases, Intensive Care Med, 1995; 21: 687-690 Search in Google Scholar

[15] Rayess H.M., Revenaugh P.C., Benninger M.S., Knott P.D., Predictive factors for patient outcomes following open bedside tracheotomy, Laryngoscope, 2013; 123: 923-928, doi: 10.1002/ lary.23887 10.1002/lary.23887Search in Google Scholar PubMed

Received: 2013-10-31
Accepted: 2014-9-26
Published Online: 2014-12-29

© 2015 Andrej Markota et al.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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