GKD Anest Yoð Bak Dern Derg. 2019; 25(3): 210-215 | DOI: 10.5222/GKDAD.2019.08860

Tracheostomy experience in two patients with cranial bleeding after LVAD (left ventricular assist device)

Mine Altýnkaya Çavuþ¹, Þerife Gökbulut Bektaþ², Sema Turan^2
1Kayseri City Hospital, Kayseri, Turkey
²AnkaraCity Hospital, Ankara, Turkey

Background: The number of heart transplantations has decreased in recent years and the number of implanted left ventricular assist devices (LVADs) has increased significantly. In addition, due to the current condition of these patients, the duration of stay in intensive care and mechanical ventilation increases. Percutaneous dilatational tracheostomy (PDT) is applied to these patients due to the need for prolonged mechanical ventilation. Complications may occur in this period due to the use of anticoagulant therapy.
Case presentation: Our cases were 2 patients who had anticoagulant and antiplatelet therapy due to LVAD, who had hemorrhagic SVO and had prolonged MV. This leads to the necessity of tracheostomy.
Conclusions: Bleeding complications cannot be excluded in these patients who have to take anticoagulant therapy.

Keywords: Tracheostomy, cranial bleeding, LVAD (left ventricular assist device)

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LVAD (left ventriküler assist device) sonrasý kraniyal kanama geliþen iki olguda trakeostomi deneyimimiz

Mine Altýnkaya Çavuþ¹, Þerife Gökbulut Bektaþ², Sema Turan^2
1Kayseri Þehir Hastanesi, Kayseri, Türkiye
²Ankara Þehir Hastanesi, Ankara, Türkiye

Amaç: Son yýllarda kalp nakli sayýsý azalmýþ ve implante edilmiþ sol ventrikül destek cihazlarýnýn (LVAD) sayýsý önemli ölçüde artmýþtýr. Ek olarak, bu hastalarýn mevcut durumundan dolayý, yoðun bakýmda ve mekanik ventilasyonda kalma süresi artar. Uzun süreli mekanik ventilasyon ihtiyacý nedeniyle bu hastalara perkütan dilatasyonel trakeostomi (PDT) uygulanýr. Antikoagülan tedavi kullanýmý nedeniyle bu dönemde komplikasyonlar görülebilir.
Olgu sunumu: Olgularýmýz LVAD nedeniyle antikoagülan ve antiplatelet tedavisi alan, hemorajik SVO ve uzun süreli mekanik ventilasyon desteði alan 2 hasta idi. Bu durum trakeostomi gerekliliðine yol açar.
Sonuç: Antikoagülan tedavi almak zorunda olan bu hastalarda kanama komplikasyonlarý göz ardý edilemez.

Anahtar Kelimeler: Trakeostomi, kranial kanama, LVAD (sol ventrikül destek cihazý)

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