F. Blot et al., SAFETY OF TRACHEOTOMY IN NEUTROPENIC PATIENTS - A RETROSPECTIVE STUDYOF 26 CONSECUTIVE CASES, Intensive care medicine, 21(8), 1995, pp. 687-690
Objective: To evaluate the safety of tracheotomy in neutropenic ventil
ated cancer patients, in terms of infectious and haemorrhagic complica
tions. Design: Retrospective study. Setting: A medical-surgical intens
ive care unit in a Cancer-hospital. Patients and participants: 26 cons
ecutive 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 patien
ts undergoing a tracheotomy, the characteristics and duration of both
neutropenia and mechanical ventilation have been recorded. Stomal blee
ding 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 obs
erved. Neither stomal nor pulmonary infections secondary to tracheotom
y were noted. No respiratory worsening was attributable to the tracheo
tomy. Nineteen patients (73%) died in ICU, without direct link between
tracheotomy and death. Conclusions: These findings suggest that a tra
cheotomy can be safely performed in neutropenic patients requiring mec
hanical ventilation.