INTRODUCTION OF A NEW TRACHEOSTOMY EXCHANGE DEVICE AFTER PERCUTANEOUSTRACHEOSTOMY IN A PATIENT WITH COAGULOPATHY

Presented is a case of a 22-year-old male bone marrow transplant recip ient who developed severe methotrexate-induced oropharyngeal mucositis and respiratory insufficiency caused by sepsis, Coagulopathy and seve re thrombocytopenia precluded surgical tracheostomy; however, dilatati onal percutaneous tracheostomy was performed uneventfully. The tracheo stomy tube was later changed using a newly developed exchange device p ermitting intraprocedural oxygenation and stomal redilatation. We conc lude that severe thrombocytopenia and coagulopathy are not an absolute contraindication for percutaneous tracheostomy and that the new trach eostomy exchange device optimizes airway management and safety during this procedure.