Cargando…

Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience

AIMS: To study the bleeding complications in patients undergoing percutaneous tracheostomy and who are at high risk of these complications (due to thrombocytopenia, use of anticoagulant or antiplatelet agents, and difficult anatomy). MATERIALS AND METHODS: A retrospective study was undertaken, which...

Descripción completa

Detalles Bibliográficos
Autores principales: Sasane, Sachin P, Telang, Madhavi M, Alrais, Zeyad F, Alrahma, Ali HNS, Khatib, Khalid I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075057/
https://www.ncbi.nlm.nih.gov/pubmed/32205938
http://dx.doi.org/10.5005/jp-journals-10071-23341
_version_ 1783506965516779520
author Sasane, Sachin P
Telang, Madhavi M
Alrais, Zeyad F
Alrahma, Ali HNS
Khatib, Khalid I
author_facet Sasane, Sachin P
Telang, Madhavi M
Alrais, Zeyad F
Alrahma, Ali HNS
Khatib, Khalid I
author_sort Sasane, Sachin P
collection PubMed
description AIMS: To study the bleeding complications in patients undergoing percutaneous tracheostomy and who are at high risk of these complications (due to thrombocytopenia, use of anticoagulant or antiplatelet agents, and difficult anatomy). MATERIALS AND METHODS: A retrospective study was undertaken, which included all patients undergoing percutaneous tracheostomy in the medical intensive care unit (MICU) of Rashid Hospital, Dubai, over a period of 15 months. Percutaneous tracheostomy was performed by senior medical intensivists using the single-tapered dilator technique under fiber optic bronchoscopic guidance. All patients underwent ultrasonographic evaluation of the neck to look for difficult anatomy and to determine the size of tracheostomy tube, etc. Patients were divided into two groups, those who were deemed to be at high risk of bleeding complications were compared with patients without any risk factors for bleeding complications. Other complications such as pneumothorax and tracheal leak were also looked for and were documented, if present. The data were summarized using descriptive statistics and the Fischer's exact test of significance was used for frequency distribution cross tables, at 5% level of significance (p value cutoff <0.05). RESULTS: One hundred and fifty-nine patients underwent percutaneous tracheostomy during the period of study. The age-group of patients ranged from 21 years to 104 years and males were predominant (65.41%). Of the 87 (54.71%) patients with one or more risk factors for bleeding, 53 (60.92%) patients had at least one risk factor for bleeding complications, while 34 (39.08%) had more than one risk factors. Bleeding was seen in total of two patients out of which one patient was in the group at risk of bleeding complications. CONCLUSION: Percutaneous tracheostomy is a relatively safe procedure with very low rate of complications when performed with due precautions. Even in patients deemed to be at high risk of complications, the rate of complications is very low. HOW TO CITE THIS ARTICLE: Sasane SP, Telang MM, Alrais ZF, Alrahma AHNS, Khatib KI. Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience. Indian J Crit Care Med 2020;24(2):90–94.
format Online
Article
Text
id pubmed-7075057
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Jaypee Brothers Medical Publishers
record_format MEDLINE/PubMed
spelling pubmed-70750572020-03-23 Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience Sasane, Sachin P Telang, Madhavi M Alrais, Zeyad F Alrahma, Ali HNS Khatib, Khalid I Indian J Crit Care Med Original Article AIMS: To study the bleeding complications in patients undergoing percutaneous tracheostomy and who are at high risk of these complications (due to thrombocytopenia, use of anticoagulant or antiplatelet agents, and difficult anatomy). MATERIALS AND METHODS: A retrospective study was undertaken, which included all patients undergoing percutaneous tracheostomy in the medical intensive care unit (MICU) of Rashid Hospital, Dubai, over a period of 15 months. Percutaneous tracheostomy was performed by senior medical intensivists using the single-tapered dilator technique under fiber optic bronchoscopic guidance. All patients underwent ultrasonographic evaluation of the neck to look for difficult anatomy and to determine the size of tracheostomy tube, etc. Patients were divided into two groups, those who were deemed to be at high risk of bleeding complications were compared with patients without any risk factors for bleeding complications. Other complications such as pneumothorax and tracheal leak were also looked for and were documented, if present. The data were summarized using descriptive statistics and the Fischer's exact test of significance was used for frequency distribution cross tables, at 5% level of significance (p value cutoff <0.05). RESULTS: One hundred and fifty-nine patients underwent percutaneous tracheostomy during the period of study. The age-group of patients ranged from 21 years to 104 years and males were predominant (65.41%). Of the 87 (54.71%) patients with one or more risk factors for bleeding, 53 (60.92%) patients had at least one risk factor for bleeding complications, while 34 (39.08%) had more than one risk factors. Bleeding was seen in total of two patients out of which one patient was in the group at risk of bleeding complications. CONCLUSION: Percutaneous tracheostomy is a relatively safe procedure with very low rate of complications when performed with due precautions. Even in patients deemed to be at high risk of complications, the rate of complications is very low. HOW TO CITE THIS ARTICLE: Sasane SP, Telang MM, Alrais ZF, Alrahma AHNS, Khatib KI. Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience. Indian J Crit Care Med 2020;24(2):90–94. Jaypee Brothers Medical Publishers 2020-02 /pmc/articles/PMC7075057/ /pubmed/32205938 http://dx.doi.org/10.5005/jp-journals-10071-23341 Text en Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd. © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Article
Sasane, Sachin P
Telang, Madhavi M
Alrais, Zeyad F
Alrahma, Ali HNS
Khatib, Khalid I
Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience
title Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience
title_full Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience
title_fullStr Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience
title_full_unstemmed Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience
title_short Percutaneous Tracheostomy in Patients at High Risk of Bleeding Complications: A Retrospective Single-center Experience
title_sort percutaneous tracheostomy in patients at high risk of bleeding complications: a retrospective single-center experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075057/
https://www.ncbi.nlm.nih.gov/pubmed/32205938
http://dx.doi.org/10.5005/jp-journals-10071-23341
work_keys_str_mv AT sasanesachinp percutaneoustracheostomyinpatientsathighriskofbleedingcomplicationsaretrospectivesinglecenterexperience
AT telangmadhavim percutaneoustracheostomyinpatientsathighriskofbleedingcomplicationsaretrospectivesinglecenterexperience
AT alraiszeyadf percutaneoustracheostomyinpatientsathighriskofbleedingcomplicationsaretrospectivesinglecenterexperience
AT alrahmaalihns percutaneoustracheostomyinpatientsathighriskofbleedingcomplicationsaretrospectivesinglecenterexperience
AT khatibkhalidi percutaneoustracheostomyinpatientsathighriskofbleedingcomplicationsaretrospectivesinglecenterexperience