Purpose@#A
tracheostomy is often used to wean
patients off the
ventilator , as it helps maintain
extracorporeal membrane oxygenation (ECMO) without sedation. A percutaneous dilatational
tracheostomy (PDT) performed in
critically ill patients is widely accepted, however, its feasibility and
safety in ECMO is unclear. @*
Methods @#This retrospective
observational study included 78
patients who underwent a PDT and ECMO at the
surgical intensive care unit (SICU) in a
tertiary hospital between January 1, 2016 and December 31, 2019. We analyzed their
medical records , including PDT-related
complications and clinical variables. @*Results@#The median values of
hemoglobin ,
platelet count ,
international normalized ratio ,
partial thromboplastin time , and
activated partial thromboplastin time before the
tracheostomy were 9.2 (8.5-10.2) g/dL, 81 (56-103) × 103/dL, 1.22 (1.13-1.30), 15.2 (14.3-16.1) seconds, and 55.1 (47.4-61.1) seconds, respectively. No clotting was observed within the extracorporeal circuit, however, minimal
bleeding was observed at the
tracheostomy site in 10 (12.8%)
patients . Of 4
patients with major
bleeding , local
hemorrhage was controlled in 3
patients , and intratracheal
bleeding continued in 1
patient . The mortality rate was 60.9% and 57.1% in the complication and no-complication group, respectively. The durations of SICU
stay, hospital stay, and
mechanical ventilation were not statistically different between the groups. @*Conclusion@#A PDT performed in
critically ill patients was associated with a low rate of
bleeding .
Complications did not appear to significantly
affect the
patient outcome. PDT can be performed in
patients who usually require a
tracheostomy to maintain ECMO.