Safety of tracheotomy in neutropenic patients: A retrospective study of 26 consecutive cases

1432-1238

Tracheotomy ; Edotracheal intubation ; Mechanical ventilation ; Neutropenia ; Cancer

Springer Online Journal Archives 1860-2000

Medicine

Abstract Objective To evaluate the safety of tracheotomy in neutropenic ventilated cancer patients, in terms of infectious and haemorrhagic complications. Design Retrospective study. Setting A medical-surgical intensive care unit in a Cancer-hospital.Patients and participants: 26 consecutive patients undergoing a tracheotomy in neutropenic period, from 1987 to 1990. Interventions Tracheotomy, performed at the bedside or in operating, room. Measurements and 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 traceotomy 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.

Electronic Resource