{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:31:24Z","timestamp":1760059884438,"version":"build-2065373602"},"reference-count":59,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Antiplatelet therapy (APT) increases bleeding risk and is frequently used in patients who undergo percutaneous dilatational tracheostomy (PDT). However, there are different techniques for single-step PDTs, which can be differently invasive. The aim of the present study was to investigate complications in patients undergoing PDT while being on APT, especially with regard to bleeding and the influence of different PDT techniques. Material and Methods: Between July 2016 and June 2021, 273 intensive care unit (ICU) patients underwent in-house PDT with two different techniques (direct or indirect) and were retrospectively enrolled. Results: A total of 273 patients (mean age: 68 years, 37% female) were included in the study. A total of 51% of patients were on APT on the day of PDT procedure (SAPT: 34%, DAPT: 17%). Direct and indirect PDTs were performed in 33% and 67% of patients. Periprocedural airway or skin bleedings and postprocedural bleedings occurred in 53%, 11%, and 1%. A need for bronchoscopic re-intervention was observed in 2% of APT patients. No death was procedure related. Periprocedural airway bleedings occurred more frequent in \u201cAPT patients\u201d (60% vs. 46%, p = 0.03). Periprocedural airway and skin bleedings were more frequent in indirect PDTs (52% and 14%) than direct PDTs (32% and 0%, p = 0.04 and p = 0.02) in \u201cno APT patients\u201d. In \u201cAPT patients\u201d this difference was only seen in periprocedural airway bleeding (69% vs. 45%, p = 0.01). Moreover, periprocedural airway bleedings were more frequent in \u201cAPT patients\u201d when performing an indirect PDT rather than a direct PDT (69% vs. 52%, p = 0.02). Conclusions: PDTs appear to be safe in patients receiving APT. Indirect PDTs appear to generally increase the risk of clinically irrelevant, minor periprocedural airway and possibly skin bleedings, especially in APT patients.<\/jats:p>","DOI":"10.3390\/jcm14145036","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T12:55:00Z","timestamp":1752670500000},"page":"5036","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Safety of Percutaneous Dilatational Tracheostomies in Patients with Antiplatelet Therapy\u2014A Comparison of Two Single-Step Percutaneous Dilatational Techniques"],"prefix":"10.3390","volume":"14","author":[{"given":"Lukas","family":"Ley","sequence":"first","affiliation":[{"name":"Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa Kerem","family":"Cinar","sequence":"additional","affiliation":[{"name":"Asklepios Neurologische Klinik Bad Salzhausen, 63667 Nidda, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Windhorst","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Justus-Liebig-University, 35392 Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Allendoerfer","sequence":"additional","affiliation":[{"name":"Asklepios Neurologische Klinik Bad Salzhausen, 63667 Nidda, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein Ardeschir","family":"Ghofrani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), 35392 Giessen, Germany"},{"name":"Department of Pneumology, Kerckhoff Heart and Thorax Center, 61231 Bad Nauheim, Germany"},{"name":"Department of Medicine, Imperial College London, London SW7 2AZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-5195","authenticated-orcid":false,"given":"Dirk","family":"Bandorski","sequence":"additional","affiliation":[{"name":"Asklepios Neurologische Klinik Bad Salzhausen, 63667 Nidda, Germany"},{"name":"Faculty of Medicine, Semmelweis University Campus Hamburg, Lohm\u00fchlenstra\u00dfe 5, 20099 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.1111\/bcp.13709","article-title":"The \u2018top 100\u2019 drugs and classes in England: An updated \u2018starter formulary\u2019 for trainee prescribers","volume":"84","author":"Audi","year":"2018","journal-title":"Br. 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