Bleeding Complications Associated With Percutaneous Tracheostomy Insertion in Patients Supported With Venovenous Extracorporeal Membrane Oxygen Support: A 10-Year Institutional Experience

Abstract

Objectives: To evaluate the bleeding complications associated with percutaneous tracheostomy while a patient is receiving venovenous extracorporeal membrane oxygen (VV ECMO) support.

Design: Retrospective, observational analysis.

Setting: Single-center, tertiary, academic institution.

Participants: All consecutive patients on VV ECMO over a 10 year-period undergoing percutaneous tracheostomy.

Interventions: Percutaneous tracheostomy.

Measurements and main results: Fifty percutaneous tracheostomies were performed in patients requiring VV ECMO support over the 10-year period. The authors observed a 40% incidence of bleeding, with 32% of these incidences characterized as minor (self-limiting, localized stomal ooze) and 8% characterized as significant (necessitating surgical control and frequent packing or accompanied by a decrease in hemoglobin >20%).

Conclusions: Bleeding is associated with percutaneous tracheostomy and is self-limiting in the majority of patients.

Keywords: bleeding; complications; percutaneous tracheostomy; venovenous extracorporeal membrane oxygenation.