Surgical tracheotomy performed with and without dual antiplatelet therapy

Andrej Markota 1 , Andreja Sinkovič 1 , and Bogdan Čizmarević 2
  • 1 Medical Intensive Care Unit, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia
  • 2 Ear, Nose and Throat Diseases Department, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia


Some patients who need dual antiplatelet therapy sometimes require tracheotomy. Aim of this study was to compare the rate of complications during and after surgical tracheotomy between patients requiring dual antiplatelet therapy and those without dual antiplatelet therapy. We retrospectively included 79 patients (62% men, mean age 64 ± 14 years) in the period 2007- 2011. The following complications were analyzed: need for surgical revision within 24 hours after tracheotomy, need for bronchoscopy within 24 hour after tracheotomy, need for blood transfusion within 24 hours after tracheotomy, death attributed to tracheotomy and any complication attributed to tracheotomy. We compared patients where tracheotomy was performed while receiving dual antiplatelet therapy (n=27, 34%) to patients where tracheotomy was performed without dual antiplatelet therapy (n=52, 66%). Nonsignificant differences between the two groups were observed general characteristics. There were no statistically significant differences in complications after tracheotomy (surgical revision after tracheotomy p=0.63, bronchoscopy after tracheotomy p=0.74, blood transfusion after tracheotomy p=0.59, death attributed to tracheotomy p=1.00 and any complication attributed to tracheotomy p=1.00). The study shows that tracheotomy is safe in cardiac patients on dual antiplatelet therapy.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • [1] Hsu C.L., Chen K.Y., Chang C.H., Jerng J.S., Yu C.J., Yang P.C., Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study, Crit. Care., 2005; 9: R46-5

  • [2] Heffner J.E., Miller K.S., Sahn S.A., Tracheostomy in the intensive care unit. Part 1: Indications, technique, management, Chest, 1986; 90: 269-274

  • [3] Combes A., Luyt C.E., Nieszkowska A., Trouillet J.L., Gibert C., Chastre J., Is tracheostomy associated with better outcomes for patients requiring long-term mechanical ventilation?, Crit. Care. Med., 2007; 35: 802-807

  • [4] Heffner J.E., Medical indications for tracheotomy, Chest, 1989; 96: 186-190

  • [5] Upadhyay A., Maurer J., Turner J., Tiszenkel H., Rosengart T., Elective bedside tracheostomy in the intensive care unit, J. Am. Coll. Surg., 1996; 183: 51-55

  • [6] Korte W., Cattaneo M., Chassot P.G., Eichinger S., von Heymann C., Hofmann N. et al., Peri-operative management of antiplatelet therapy in patients with coronary artery disease: joint position paper by members of the working group on Perioperative Haemostasis of the Society on Thrombosis and Haemostasis Research (GTH), the working group on Perioperative Coagulation of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care (ÖGARI) and the Working Group Thrombosis of the European Society for Cardiology (ESC), Thromb. Haemost., 2011; 105: 743-749, doi: 10.1160/TH10-04-0217

  • [7] Fitchett D., Eikelboom J., Fremes S., Mazer D., Singh S., Bittira B. et al., Dual antiplatelet therapy in patients requiring urgent coronary artery bypass grafting surgery: a position statement of the Canadian Cardiovascular Society, Can. J. Cardiol., 2009; 25: 683-689

  • [8] Voigt I., Naber C., Bleeding complications of percutaneous dilatation tracheostomy (PDT) in a group of ICU patients with dual antiplatelet therapy, Crit. Care. Shock, 2012; 15: 70-76

  • [9] Sharma S.C., Singh V.K., Anand A., Rao B.K., Percutaneous tracheostomy in patients with coagulopathy, In: J.D. Chiche (Ed.), Abstract of the 23rd ESICM Annual Congress, 2010: 163

  • [10] Beiderlinden M., Eikermann M., Lehmann N., Adamzik M., Peters J., Risk factors associated with bleeding during and after percutaneous dilational tracheostomy, Anaesthesia, 2007; 62: 342-346

  • [11] Kluge S., Meyer A., Kühnelt P., Baumann H.J., Kreymann G., Percutaneous tracheostomy is safe in patients with severe thrombocytopenia, Chest, 2004; 126: 547-551

  • [12] Auzinger G., O’Callaghan G.P., Bernal W., Sizer E., Wendon J.A., Percutaneous Tracheostomy in patients with severe liver disease and a high incidence of refractory coagulopathy: a prospective trial, Crit. Care., 2007; 11: R110

  • [13] Blankenship D.R., Kulbersh B.D., Gourin C.G., Blanchard A.R., Terris D.J., High-risk tracheostomy: exploring the limits of the percutaneous tracheostomy, Laryngoscope, 2005; 115: 987-989

  • [14] Blot F., Nitenberg G., Guiguet M., Casetta M., Antoun S., Pico J.L. et al., Safety of tracheotomy in neutropenic patients: a retrospective study of 26 consecutive cases, Intensive Care Med, 1995; 21: 687-690

  • [15] Rayess H.M., Revenaugh P.C., Benninger M.S., Knott P.D., Predictive factors for patient outcomes following open bedside tracheotomy, Laryngoscope, 2013; 123: 923-928, doi: 10.1002/ lary.23887


Journal + Issues