CLDF Title
Home | Contact Us | Bookmark
HBV HE HCC HCV
About CLDF Centers of Educational Expertise  
CME Dinner Meetings Webcasts Slide Library Abstract Library Conference Highlights
 
Back  
 
Reuters Health Information (2007-11-05): Percutaneous tracheostomy seen safe in liver disease with coagulopathy

Clinical

Percutaneous tracheostomy seen safe in liver disease with coagulopathy

Last Updated: 2007-11-05 16:23:42 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The first comprehensive, prospective study of percutaneous dilational tracheostomy (PDT) in patients with severe liver diseases indicates that the procedure is safe when performed by an experienced operator, even in patients with refractory coagulopathy.

The researchers note in the October 8 issue of Critical Care that as guide wire-assisted PDT has been increasingly used in ICUs worldwide since its introduction approximately 20 years ago, "indications for PDT have been extended to include patients with previously defined contraindications."

The current study by Dr. Georg Auzinger and colleagues involved 60 consecutive patients (over a 7-month period) in a 10-bed specialized liver intensive care unit at King's College Hospital, London, UK.

Of the 60 patients, 25 were identified as having refractory coagulopathy on the day of PDT and for 72 hours following, despite clotting support. Clotting support included standard doses of fresh frozen plasma and platelets.

The PDTs were performed by personnel who had each performed at least 75 such procedures previously.

Only one patient died during the 72-hour observation period following PDT, from multiple organ failure not related to the PDT. Overall hospital mortality was 50%.

No deaths were related to the PDTs, and there was an overall low rate of clinically significant PDT-related bleeding complications.

In addition, there was no significant difference in the numbers of adverse incidents between the group with refractory coagulopathy and the group with little or no coagulopathy, and hospital survival did not differ between the two groups.

"We conclude that refractory coagulopathy associated with liver disease is not a contraindication for PDT," write Dr. Auzinger and colleagues. "To the contrary, the relative atraumatic nature of the procedure compared to the open surgical approach makes it an attractive alternative in this setting."

Crit Care 2007;11.

 
 
 
 
                 
 
HBV
Webcasts
Slide Library
Abstract Library
 
HE
CME Dinner Meeting
Webcasts
Slide Library
Abstract Library
 
HCC
Slide Library
Abstract Library
 
 
HCV
Webcasts
Slide Library
Abstract Library
 
CLDF Follow Us
   
 
About CLDF
Mission Statement
Board of Trustees
Board of Advisors
CLDF Supporters
 
Other Resources
Liver News Library
Journal Abstracts
Hep C Link to Care
 
Centers of
Educational Expertise
Regional Map
     
   
  The Chronic Liver Disease Foundation is a non-profit organization with content developed specifically for healthcare professionals.
© Copyright 2012-2014 Chronic Liver Disease Foundation. All rights reserved. This site is maintained as an educational resource for US healthcare providers only.
Use of this Web site is governed by the Chronic Liver Disease Foundation terms of use and privacy statement.