Safety of Percutaneous Tracheostomy in Patients with Liver Disease
Author Information
Author(s): Auzinger Georg, O'Callaghan Gerry P, Bernal William, Sizer Elizabeth, Wendon Julia A
Primary Institution: Institute of Liver Studies, Liver Intensive Care Unit, King's College Hospital
Hypothesis
The study aims to assess the safety of percutaneous dilational tracheostomy (PDT) in critically ill patients with liver disease and coagulopathy.
Conclusion
PDT is safe and not contraindicated in patients with severe liver disease and refractory coagulopathy.
Supporting Evidence
- Only one patient in the coagulopathy group had a severe bleeding complication.
- The rate of clinically relevant early complications in all patients was not higher than expected.
- Hospital survival did not differ between groups.
Takeaway
Doctors can safely perform a procedure called tracheostomy on very sick patients with liver problems, even if their blood doesn't clot well.
Methodology
A prospective cohort study conducted in a liver intensive care unit involving 60 consecutive patients needing tracheostomy.
Limitations
The study did not use routine bronchoscopic guidance for PDT.
Participant Demographics
Patients included were critically ill with liver disease, with a mean age of 42 years.
Statistical Information
P-Value
p = 0.009 for platelet transfusions, p = 0.029 for patients requiring platelet transfusions.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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