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Coagulation disorders do not increase the risk for bleeding during percutaneous dilatational tracheotomy
Antje-Christin Deppe1, Elmar Kuhn, Maximilian Scherner
1Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany.
The Thoracic and Cardiovascular Surgeon
|January 25, 2013
Summary
Percutaneous dilatational tracheotomy (PDT) is safe in patients with coagulation disorders. This study found no increased bleeding risk, meaning anticoagulation does not need to be stopped before PDT.
Area of Science:
- Medical Procedures
- Critical Care Medicine
- Cardiovascular Surgery
Background:
- Percutaneous dilatational tracheotomy (PDT) is a common procedure.
- Coagulation disorders are a relative contraindication for PDT, often requiring hemostasis normalization.
- Patients with cardiac assist devices require adequate anticoagulation, complicating PDT.
Purpose of the Study:
- To investigate the risk of bleeding complications in patients undergoing PDT with impaired hemostasis.
- To evaluate the safety of PDT in patients with coagulation disorders.
Main Methods:
- Retrospective study of 213 patients undergoing PDT from November 2007 to November 2010.
- Patients stratified into high-risk (HR) and low-risk (LR) groups based on bleeding risk factors.
- Assessed factors included activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), and platelet count.
Main Results:
- No significant difference in bleeding complications between HR (5/85) and LR (8/128) groups.
- All observed bleeding events were mild and did not require surgical intervention or transfusion.
- No severe bleeding or other procedure-related complications were reported.
Conclusions:
- Percutaneous dilatational tracheotomy is a safe and feasible procedure in patients with coagulation disorders.
- Discontinuation of anticoagulation or hemostasis normalization is not necessary prior to PDT.
- PDT can be safely performed without compromising patient safety in anticoagulated individuals.
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