Thorac Cardiovasc Surg 2013; 61(03): 234-239
DOI: 10.1055/s-0032-1322608
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Coagulation Disorders Do Not Increase the Risk for Bleeding during Percutaneous Dilatational Tracheotomy

Antje-Christin Deppe
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
,
Elmar Kuhn
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
,
Maximilian Scherner
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
,
Ingo Slottosch
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
,
Oliver Liakopoulos
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
,
Georg Langebartels
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
,
Yeong-Hoon Choi
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
2   Center of Molecular Medicine, University of Cologne, Cologne, Germany
*   Both authors contributed equally to this work.
,
Thorsten Wahlers
1   Department of Cardiothoracic Surgery, Heart Center of the University of Cologne, Cologne, Germany
*   Both authors contributed equally to this work.
› Author Affiliations
Further Information

Publication History

26 November 2011

12 March 2012

Publication Date:
23 January 2013 (online)

Abstract

Background Percutaneous dilatational tracheotomy (PDT) is a common procedure. Coagulation disorders represent a relative contraindication for PDT and, therefore, normalization of hemostasis parameters is recommended. Especially patients undergoing cardiac surgery after valve replacement and with any kind of assist device need to require an adequate anticoagulation. This study investigated the impact of impaired hemostasis as a risk factor for bleeding complications retrospectively.

Methods Patients who underwent PDT (November 2007 to November 2010) were stratified into a high-risk (HR) and low-risk (LR) group in regard to bleeding complications. The following determining factors activated partial thromboplastin time (aPTT > 50 seconds, prothrombin time (PT < 50%), international normalized ratio (INR > 1.4), and platelet count (< 50,000/µL) were assessed.

Results A total of 213 patients underwent PDT (HR = 5/85; LR = 8/128). There was no difference in demographics or intraoperative data. Patients of both groups showed mild bleeding without the need for surgical intervention or transfusion (p = 0.957). There were no severe bleeding nor other procedure-related complications.

Conclusion Percutaneous tracheotomy is a safe and feasible procedure in patients with coagulation disorders. Therefore, discontinuation of anticoagulation treatment or normalization of hemostasis prior to the procedure is not necessary.

 
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