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A Case Series of Bleeding Complication Post Percutaneous Dilatational Tracheostomy and Management Lubis, Batian; Purwaamidjaja, Dis Bima P; Lestari, Mayang Indah; Faisal; Thamrin, Muhammad Husni; Belinda, Febri Akhmad
Journal of Society Medicine Vol. 2 No. 12 (2023): December
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i12.108

Abstract

Introduction: Percutaneous Dilatational Tracheotomy (PDT) is a procedure established for the management of airway and ventilation in the medium to long term for critically ill patients in the ICU. Bleeding is one of the most frequent early complications of tracheostomy. The comorbid conditions of critically ill patients increase the risk of bleeding complications. The aim of this case was to identify factors that increase the risk of bleeding complications in critically ill patients undergoing Percutaneous Dilatational Tracheostomy (PDT) and its management Case: Two cases of patients experiencing bleeding complications after PDT were reported. The bleeding in these patients were suspected to be caused by coagulation disorders due to sepsis and chronic kidney disease. The bleeding occurred on day-1 and 2 post-PDT procedure. Bleeding complications that were not resolved with general management were managed by subcutaneous suturing in the anatomical region of branching arteries and veins that supply the trachea. Conclusion: Bleeding after PDT are a part of early complications of tracheostomy procedures. This complication is more often found in critically ill patients. Management can be carried out by suturing the anatomical region of branching arteries and veins supplying the trachea.
Strategies for Successful Anesthetic Management in Patients With Threatened Thyroid Storm: a Systematic Review of Case Reports Fitrisyah, Aidyl; Sofiah, Nur Ilmi; Murtadh, Masagus Ahmad Rifqi; Lestari, Mayang Indah
Jurnal Inovasi Global Vol. 3 No. 11 (2025): Jurnal Inovasi Global
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jig.v3i11.450

Abstract

Patients with uncontrolled hyperthyroidism undergoing emergency non-thyroid-related surgeries are at increased risk of perioperative complications, including thyroid storm (TS). This systematic review synthesizes findings from multiple case reports to determine optimal anesthetic management strategies. A systematic review of published case reports, including an additional case report contributed by the authors, was conducted. Cases were analyzed for anesthetic strategies, perioperative complications, and outcomes, with a focus on TS occurrence, survival rates, and risk factors. Five case reports and an additional case were reviewed. The use of beta-blockers, glucocorticoids, antithyroid drugs, and regional anesthesia was found to mitigate TS risk. General anesthesia was employed in most cases, with vigilant intraoperative monitoring. TS was reported in one case, emphasizing the need for early recognition and aggressive management. Comprehensive preoperative assessment, intraoperative vigilance, and postoperative monitoring are critical in managing patients with uncontrolled hyperthyroidism undergoing emergency surgery. Beta-blockers, steroids, and regional anesthesia appear to be key in minimizing TS risk.