title: Percutaneous dilational tracheostomy in patients receiving antiplatelet therapy: is it safe?
abstract: Antiplatelet agents have become a mainstay therapy for vascular diseases; yet, it increases the risk of bleeding. The latter has a potential to impact the safety of invasive procedures. A retrospective chart review of patients undergoing percutaneous dilational tracheostomy (PDT) at each of the 2 institutions was performed to determine the bleeding risk for patients on antiplatelet therapy who underwent PDT. Out of the 246 patients who underwent PDT over the study period, 20 qualified for the study group. All were being treated with clopidogrel. A control group of 137 patients was created. No major bleeding occurred in either of the group. Minor bleeding occurred in 1 study patient (5%) and in 5 (3.6%) of the control patients (P=0.85). The data support the performance of PDT without stopping clopidogrel if there was a clear and ongoing indication for the antiplatelet agent.
authors.affiliation: *Division of Pulmonary and Critical Care Medicine, Cooper University Hospital, Camden, NJ †Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Wissam
authors.initials: W
authors.lastname: Abouzgheib
authors.forename: Nikhil
authors.initials: N
authors.lastname: Meena
authors.forename: Prashant
authors.initials: P
authors.lastname: Jagtap
authors.forename: Christa
authors.initials: C
authors.lastname: Schorr
authors.forename: Ziad
authors.initials: Z
authors.lastname: Boujaoude
authors.forename: Thaddeus
authors.initials: T
authors.lastname: Bartter
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D000077144:Clopidogrel; D004106:Dilatation / Q000009:adverse effects / Q000379:methods; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods*
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine