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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Safety of Prophylactic Anticoagulation During Bedside Procedures: A Prospective Multicenter Observational Study.
Cassie A Barton1, David S Shapiro2, Andrew J Webb3
1Department of Pharmacy, Oregon Health & Science University, Portland, OR, USA. bartonc@ohsu.edu.
World Journal of Surgery
|July 19, 2022
Summary
For intensive care unit patients undergoing bedside procedures like tracheostomy or gastrostomy, continuing venous thromboembolism prophylaxis is safe. Bleeding complications were rare and similar whether prophylaxis was held or not.
Area of Science:
- Critical Care Medicine
- Interventional Procedures
- Thrombosis Management
Background:
- Bedside percutaneous dilatational tracheostomy (PDT) and percutaneous endoscopic gastrostomy (PEG) are common in ICUs.
- Venous thromboembolism (VTE) prophylaxis is standard for ICU patients.
- The necessity of holding VTE prophylaxis before these procedures is unclear.
Purpose of the Study:
- To evaluate bleeding rates in patients undergoing bedside PEG or PDT.
- To compare bleeding complications between patients who had VTE prophylaxis held and those who did not.
- To assess VTE rates and factors influencing prophylaxis management.
Main Methods:
- Multi-center prospective observational study.
- Included 91 patients undergoing bedside PDT or PEG over 2 years.
- Primary endpoint: peri-procedural bleeding complications; Secondary endpoints: VTE events, prophylaxis holding patterns.
Main Results:
- Overall bleeding rate was low (1.4% with prophylaxis continued, 5.0% with prophylaxis held).
- No significant difference in bleeding complications based on prophylaxis status.
- 10 VTE events occurred, all in patients with prophylaxis continued pre-procedure.
Conclusions:
- Peri-procedural bleeding complications are rare in patients undergoing bedside PDT/PEG.
- Continuing VTE prophylaxis does not appear to increase bleeding risk.
- Further research is needed to confirm the safety of continuing prophylaxis.
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