Percutaneous dilatation tracheotomy in patients on extracorporeal membrane oxygenation after cardiac surgery

Author:

Xin Meng1,Wang Liangshan1,Li Chenglong1,Hou Dengbang1,Wang Hong1,Wang Jiangang1,Jia Ming1,Hou Xiaotong1

Affiliation:

1. Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

Abstract

Background Current practices regarding percutaneous dilatational tracheostomy in adult patients treated with extracorporeal membrane oxygenation (ECMO) after cardiac surgery is not completely defined. This study aimed to evaluate the safety of the percutaneous dilatational tracheostomy in patients with ECMO after cardiac surgery. Methods Between July 2017 and May 2021, 371 ECMO procedures were performed in more than 35,000 adult patients who underwent cardiac surgery in our hospital. Sixty-two patients underwent percutaneous dilatational tracheostomy (PDT) during or after ECMO. A retrospective analysis was performed comparing the incidence of complications and clinical outcomes of the two groups. Results Of the 371 patients treated with ECMO after adult cardiac surgery during the enrollment period, 22 (7.1%) and 40 (12.8%) underwent PDT during or after ECMO, respectively. The platelet count (PLT) of the day was significantly lower in the PDT during ECMO group (54 (34, 68) vs. 108 (69, 162) (thousands), p < 0.001)). The prothrombin time (PT) and activated partial thromboplastin time (APTT) of the day were longer in the PDT during ECMO group (15.8 (14.6, 19.9) vs. 13.8 (13.2, 15.2) seconds, p = 0.001, 43.8 (38.0, 49.4) vs. 35.2 (28.2, 40.9) seconds, p < 0.001, respectively). There was no significant difference in tracheotomy-related complications between the two groups. Significantly decreased ventilator time was observed in the PDT during ECMO group. Conclusions Despite poor coagulation of the day, PDT during ECMO is safe and can appropriately reduce the duration of mechanical ventilation compared with PDT after ECMO weaning in adult patients who have undergone cardiac surgery.

Funder

Beijing Hospital Authority “Ascent plan”

Publisher

SAGE Publications

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Safety Research,Radiology, Nuclear Medicine and imaging,General Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Nomogram and Risk Calculator for Postoperative Tracheostomy after Heart Valve Surgery;Journal of Cardiovascular Development and Disease;2023-02-08

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