Open tracheostomy in patients with dual platelet aggregation inhibitors: case series
Abstract
Introduction:
Tracheostomy is the most common surgical procedure performed in the intensive care unit (ICU). There is a paucity of evidence regarding complications in patients on dual anti-platelet therapy.
Objective:
To describe the complications arising in critically ill patients on dual antiplatelet therapy who are subjected to open tracheostomy.
Method:
Descriptive observational study of a retrospective case series of patients admitted to the ICU between June 2011 and December 2016, scheduled to undergo open tracheostomy.
Results:
Overall, 52 patients met the inclusion criteria and, of them, 14 were excluded. Postoperatively, 4 patients (10.5%) had major bleeding and 2 (5.3%) had minor bleeding. Only 1 patient (2.6%) required transfusion secondary to tracheostomy-related bleeding. No patient required fiberoptic bronchoscopy due to bleeding. Reintervention was needed in 10.5% of patients (n=4). No tracheostomy-related mortality was reported.
Conclusion:
Although 10.5% of patients had major bleeding, there was no impact on mortality. This study showed that, in patients with recent major cardiovascular events, there is no need to discontinue dual antiplatelet therapy or delay tracheostomy.
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