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Case Reports
Introduction of a new tracheostomy exchange device after percutaneous tracheostomy in a patient with coagulopathy.
- M Weinmann and J J Bander.
- Division of Critical Care Medicine, Harper Hospital, Detroit, Michigan 48201, USA.
- J Trauma. 1996 Feb 1; 40 (2): 317-9.
AbstractPresented is a case of a 22-year-old male bone marrow transplant recipient who developed severe methotrexate-induced oropharyngeal mucositis and respiratory insufficiency caused by sepsis. Coagulopathy and severe thrombocytopenia precluded surgical tracheostomy; however, dilatational percutaneous tracheostomy was performed uneventfully. The tracheostomy tube was later changed using a newly developed exchange device permitting intraprocedural oxygenation and stomal redilatation. We conclude that severe thrombocytopenia and coagulopathy are not an absolute contraindication for percutaneous tracheostomy and that the new tracheostomy exchange device optimizes airway management and safety during this procedure.
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