Safety of tracheotomy in neutropenic patients: a retrospective study of 26 consecutive cases.
OBJECTIVE
To evaluate the safety of tracheotomy in neutropenic ventilated cancer patients, in terms of infectious and haemorrhagic complications.


METHODS
Retrospective study.


METHODS
A medical-surgical intensive care unit in a Cancer-hospital.


METHODS
26 consecutive patients undergoing a tracheotomy in neutropenic period, from 1987 to 1990.


METHODS
Tracheotomy, performed at the bedside or in operating room.


RESULTS
In all neutropenic patients undergoing a tracheotomy, the characteristics and duration of both neutropenia and mechanical ventilation have been recorded. Stomal bleeding and infection, and infectious pneumonias and alveolar haemorrhage have been carefully reviewed. Platelets were transfused in 23 of the 26 patients at the time of the procedure; no local haemorrhage was observed. Neither stomal nor pulmonary infections secondary to tracheotomy were noted. No respiratory worsening was attributable to the tracheotomy. Nineteen patients (73%) died in ICU, without direct link between tracheotomy and death.


CONCLUSIONS
These findings suggest that a tracheotomy can be safely performed in neutropenic patients requiring mechanical ventilation.
Intensive Care Unit, Institut Gustave Roussy, Villejuif, France.
F
F
Blot
G
G
Nitenberg
M
M
Guiguet
M
M
Casetta
S
S
Antoun
J L
JL
Pico
B
B
Leclercq
B
B
Escudier
D003657:Decision Making; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D009369:Neoplasms / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D017713:Platelet Transfusion; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012449:Safety; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications; D013997:Time Factors; D014140:Tracheotomy / Q000009:adverse effects; D016896:Treatment Outcome