Annals of Cardiac Anaesthesia (Jan 2015)

Percutaneous tracheostomy in patients on anticoagulants

  • Laura Pasin,
  • Elena Frati,
  • Luca Cabrini,
  • Landoni Giovanni,
  • Pasquale Nardelli,
  • Tiziana Bove,
  • Maria Grazia Calabro,
  • Anna Mara Scandroglio,
  • Federico Pappalardo,
  • Alberto Zangrillo

DOI
https://doi.org/10.4103/0971-9784.159802
Journal volume & issue
Vol. 18, no. 3
pp. 329 – 334

Abstract

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Aims: To determine if percutaneous tracheostomy is safe in critically ill patients treated with anticoagulant therapies. Settings and Design: Single-center retrospective study including all the patients who underwent percutaneous dilatational tracheostomy (PDT) placement over a 1-year period in a 14-bed, cardiothoracic and vascular Intensive Care Unit (ICU). Materials and Methods: Patients demographics and characteristics, anticoagulant and antiplatelet therapies, coagulation profile, performed technique and use of bronchoscopic guidance were retrieved. Results: Thirty-six patients (2.7% of the overall ICU population) underwent PDT over the study period. Twenty-six (72%) patients were on anticoagulation therapy, 1 patient was on antiplatelet therapy and 2 further patients received prophylactic doses of low molecular weight heparin. Only 4 patients had normal coagulation profile and were not receiving anticoagulant or antiplatelet therapies. Overall, bleeding of any severity complicated 19% of PDT. No procedure-related deaths occurred. Conclusions: PDT was proved to be safe even in critically ill-patients treated with anticoagulant therapies. Larger prospective studies are needed to confirm our findings.

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