The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia
Background. Percutaneous dilatational tracheostomy (PDT) has become the preferred method in several intensive care units (ICUs), but data on PDT performed in immunosuppressed and thrombocytopenic patients are scarce. This study aimed to analyze the feasibility of PDT in immunosuppressed and thromboc...
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| Format: | Article |
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Wiley
2022-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/5356413 |
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| author | Marianne Angelberger Michaela Barnikel Alessia Fraccaroli Johanna Tischer Sofía Antón Alexandra Pawlikowski Mark op den Winkel Hans Joachim Stemmler Stephanie-Susanne Stecher |
| author_facet | Marianne Angelberger Michaela Barnikel Alessia Fraccaroli Johanna Tischer Sofía Antón Alexandra Pawlikowski Mark op den Winkel Hans Joachim Stemmler Stephanie-Susanne Stecher |
| author_sort | Marianne Angelberger |
| collection | DOAJ |
| description | Background. Percutaneous dilatational tracheostomy (PDT) has become the preferred method in several intensive care units (ICUs), but data on PDT performed in immunosuppressed and thrombocytopenic patients are scarce. This study aimed to analyze the feasibility of PDT in immunosuppressed and thrombocytopenic patients compared to conventional open surgical tracheostomy (OST). Methods. We retrospectively analyzed the charts of patients who underwent PDT or OST between May 2017 and November 2020. Our outcomes were stoma site infections and bleeding complications. Results. 63 patients underwent PDT, and 21 patients underwent OST. Distribution of gender ratio, age, SAPS II, time of ventilation before tracheostomy, and preexisting hematooncological diseases was comparable between the two groups. After allogeneic stem cell transplantation (alloSCT), patients were more likely to undergo PDT than OST (p=0.033). The PDT cohort suffered from mucositis more frequently (p=0.043). There were no significant differences in leucocyte or platelet count on the tracheostomy day. Patients with coagulation disorders and patients under immunosuppression were distributed equally among both groups. Stoma site infection was documented in five cases in PDT and eight cases in the OST group. Moderate infections were remarkably increased in the OST group. Smears were positive in six cases in the PDT group; none of these patients had local infection signs. In the OST group, smears were positive in four cases; all had signs of a stroma site infection. Postprocedural bleedings occurred in eight cases (9.5%) and were observed significantly more often in the OST group (p=0.001), leading to emergency surgery in one case of the OST group. Conclusion. PDT is a feasible and safe procedure in a predominantly immunosuppressed and thrombocytopenic patient cohort without an increased risk for stoma site infections or bleeding complications. |
| format | Article |
| id | doaj-art-3f5effd637b6442f80778910dc5802c5 |
| institution | Kabale University |
| issn | 2090-1313 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-3f5effd637b6442f80778910dc5802c52025-02-03T05:53:27ZengWileyCritical Care Research and Practice2090-13132022-01-01202210.1155/2022/5356413The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without ThrombocytopeniaMarianne Angelberger0Michaela Barnikel1Alessia Fraccaroli2Johanna Tischer3Sofía Antón4Alexandra Pawlikowski5Mark op den Winkel6Hans Joachim Stemmler7Stephanie-Susanne Stecher8Department of Medicine IIDepartment of Medicine VDepartment of Medicine IIIDepartment of Medicine IIIDepartment of Medicine IIDepartment of Medicine IIIDepartment of Medicine IIDepartment of Medicine IIIDepartment of Medicine IIBackground. Percutaneous dilatational tracheostomy (PDT) has become the preferred method in several intensive care units (ICUs), but data on PDT performed in immunosuppressed and thrombocytopenic patients are scarce. This study aimed to analyze the feasibility of PDT in immunosuppressed and thrombocytopenic patients compared to conventional open surgical tracheostomy (OST). Methods. We retrospectively analyzed the charts of patients who underwent PDT or OST between May 2017 and November 2020. Our outcomes were stoma site infections and bleeding complications. Results. 63 patients underwent PDT, and 21 patients underwent OST. Distribution of gender ratio, age, SAPS II, time of ventilation before tracheostomy, and preexisting hematooncological diseases was comparable between the two groups. After allogeneic stem cell transplantation (alloSCT), patients were more likely to undergo PDT than OST (p=0.033). The PDT cohort suffered from mucositis more frequently (p=0.043). There were no significant differences in leucocyte or platelet count on the tracheostomy day. Patients with coagulation disorders and patients under immunosuppression were distributed equally among both groups. Stoma site infection was documented in five cases in PDT and eight cases in the OST group. Moderate infections were remarkably increased in the OST group. Smears were positive in six cases in the PDT group; none of these patients had local infection signs. In the OST group, smears were positive in four cases; all had signs of a stroma site infection. Postprocedural bleedings occurred in eight cases (9.5%) and were observed significantly more often in the OST group (p=0.001), leading to emergency surgery in one case of the OST group. Conclusion. PDT is a feasible and safe procedure in a predominantly immunosuppressed and thrombocytopenic patient cohort without an increased risk for stoma site infections or bleeding complications.http://dx.doi.org/10.1155/2022/5356413 |
| spellingShingle | Marianne Angelberger Michaela Barnikel Alessia Fraccaroli Johanna Tischer Sofía Antón Alexandra Pawlikowski Mark op den Winkel Hans Joachim Stemmler Stephanie-Susanne Stecher The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia Critical Care Research and Practice |
| title | The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia |
| title_full | The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia |
| title_fullStr | The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia |
| title_full_unstemmed | The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia |
| title_short | The Feasibility of Percutaneous Dilatational Tracheostomy in Immunosuppressed ICU Patients with or without Thrombocytopenia |
| title_sort | feasibility of percutaneous dilatational tracheostomy in immunosuppressed icu patients with or without thrombocytopenia |
| url | http://dx.doi.org/10.1155/2022/5356413 |
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