Percutaneous Tracheostomy Is Safe in Patients With Severe Thrombocytopenia

Kluge, Stefan; Meyer, Andreas; Kühnelt, P.; Baumann, Hannes; Kreymann, G.

doi:10.1378/chest.126.2.547

Cited by 93 publications

(52 citation statements)

References 19 publications

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“…These studies have documented few bleeding complications. [81][82][83] While all of these studies are relatively small, they suggest that judicious correction of coagulopathy in the periprocedural period allows for safe PDT in the coagulopathic patient.…”

Section: High-risk Patients and Percutaneous Dilatational Tracheostomymentioning

confidence: 99%

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

2014

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Section: High-risk Patients and Percutaneous Dilatational Tracheostomymentioning

confidence: 99%

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

2014

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“…Twenty-two patients also had partial thromboplastin time (PTT) >40 sec and elevated international normalized ratio (INR) >1.5. Forty patients received platelet transfusion before the procedure and only two developed major post procedural bleeding that required suturing (23). A retrospective analysis of 177 patients who underwent PT found no significant difference in bleeding in 16 (9.0%) coagulopathic (INR ≥1.7 or platelet count ≤50 k) patients compared to those without coagulopathy (24).…”

Section: Coagulopathymentioning

confidence: 99%

Percutaneous tracheostomy: a comprehensive review

Rashid

Islam

2017

J. Thorac. Dis.

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Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world.Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population. Ultrasound can be helpful in limited cases to identify the neck structure especially in patients with a difficult anatomy. Bronchoscopy during PT can shorten the duration and avoid complications.PT has favorable complication rate, lower infection rate, shorter procedural duration and is cost-effective.Experience with the technique and careful planning is needed to minimize any avoidable potential complication.

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“…PCT has a comparable complication rate to open tracheostomy; yet to date, there is not a shared consensus as to an accepted set of contraindications for this procedure [5,7,12,20]. Numerous researchers have found patient conditions such as previous tracheostomy, inability to extend the neck, short/fat neck, enlarged thyroid and coagulopathies or anti-coagulation therapy, cervical/neck injuries, and emergency situations as relative contraindications [12,13,[16][17][18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%