Hemorrhagic Risks of Percutaneous Dilated Tracheotomy in Thrombocytopenia
https://doi.org/10.21292/2078-5658-2021-18-6-57-62
Abstract
The objective: to assess the incidence and influence of platelets level on the hemorrhagic complications during percutaneous dilated tracheotomy (PDT) in patients with thrombocytopenia.
Subjects and Methods. The study included 85 consecutive patients with varying degrees of thrombocytopenia at the stages of hematopoietic stem cell transplantation. The control group included 56 patients who underwent classical tracheotomy. The study group included 29 patients who underwent PDT (Griggs method). The operations were performed for prolonged artificial pulmonary ventilation. When the platelets level was below 20 × 109/L, platelet concentrate transfusion was performed before the operation.
Results. The incidence of hemorrhagic complications in patients with thrombocytopenia during PDT was 13.8% (95% CI 9.13–18.45%). In open tracheotomy, the bleeding rate was 3.8% (95% CI 2.65–4.49%). These results are comparable to the incidence of hemorrhagic complications in patients with normal platelet counts. The influence of the platelet level on the presence of hemorrhagic complications in both groups was not established.
Conclusion. Thrombocytopenia is not a contraindication to performing PDT. However, platelet concentrate transfusion should be performed in patients with platelet counts less than 20 × 109/L. An experienced team of anesthesiologists and endoscopists can reduce the incidence of other complications.
About the Authors
O. I. Dolgov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Oleg I. Dolgov, Candidate of Medical Sciences, Assistant of Otorhinolaryngology Department
6–8, Lva Tolstogo St., St. Petersburg, 197022
А. V. Gerasin
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Andrey V. Gerasin, Endoscopist
6–8, Lva Tolstogo St., St. Petersburg, 197022
А. А. Shcherbakov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Aleksandr A. Shcherbakov, Anesthesiologist and Emergency Physician in Intensive Care Unit no. 3, Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation
6–8, Lva Tolstogo St., St. Petersburg, 197022
Phone: +7 (812) 338–78–95
V. E. Pavlov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Vladimir E. Pavlov, Assistant of Anesthesiology and Intensive Care Department
6–8, Lva Tolstogo St., St. Petersburg, 197022
Phone: +7 (812) 338–70–19
S. А. Karpishchenko
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Sergey A. Karpishchenko, Doctor of Medical Sciences, Professor, Head of Otorhinolaryngology Department
6–8, Lva Tolstogo St., St. Petersburg, 197022
Phone: +7 (812) 338–70–19
I. S. Moiseev
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Ivan S. Moiseev, Doctor of Medical Sciences, Associate Professor of Department of Hematology, Transfusiology, and Transplantology, Post-Graduate Training Faculty
6–8, Lva Tolstogo St., St. Petersburg, 197022
Phone: +7 (812) 338–66–09
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Review
For citations:
Dolgov O.I., Gerasin А.V., Shcherbakov А.А., Pavlov V.E., Karpishchenko S.А., Moiseev I.S. Hemorrhagic Risks of Percutaneous Dilated Tracheotomy in Thrombocytopenia. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(6):57-62. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-6-57-62
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