Bleeding of Post-Tonsillectomy
Authors:
Pavel Komínek 1
; Viktor Chrobok 2
; A. Pellant 3; J. Kraus 4; V. Černý 5,6; J. Betka 7
Authors place of work:
ORL klinika, Fakultní nemocnice Ostrava, přednosta doc. MUDr. P. Komínek, Ph. D., MBA
Klinika otorinolaryngologie a chirurgie hlavy a krku, Fakultní nemocnice Hradec Králové
1; Lékařská fakulta v Hradci Králové, Univerzita Karlova v Praze, přednosta prof. MUDr. V. Chrobok, CSc., Ph. D.
Klinika otorinolaryngologie a chirurgie hlavy a krku Pardubické krajské nemocnice, a. s.
2; Fakulta zdravotnických studií Univerzity Pardubice, přednosta MUDr. J. Mejzlík, Ph. D.
3; Otorinolaryngologické oddělení, Nemocnice Rudolfa a Stefanie Benešov, a. s., primář MUDr. J. Kraus, MBA
Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Hradec Králové
4; přednosta prof. MUDr. V. Černý, Ph. D., FCCM
5; Department of Anesthesia, Pain, Management and Perioperative Medicíně Dalhousie University, Halifax, Nova Scotia, Canada
Klinika ORL a chirurgie hlavy a krku 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Motol
6; přednosta prof. MUDr. J. Betka, DrSc., FCMA
7
Published in the journal:
Otorinolaryngol Foniatr, 63, 2014, No. 1, pp. 41-49.
Category:
Survey Articles
Summary
Tonsillectomy is one of the most frequent surgeries performed by otorhinolaryngologists and bleeding is the most serious post-operative complication. Primary bleeding occurs during hospitalization of the patient and the measures can be taken immediately, whereas treatment of secondary bleeding may be problematic. In the paper, the authors give a review of the risk factors of post-tonsillectomy bleeding and the factors that influence the bleeding.
There is no clear definition of post-tonsillectomy bleeding, therefore the study results vary. Postoperative bleeding occurs in 2-15%. Questionnaire-based studies show that bleeding occurs more often than is believed among health care professionals. The bleeding is more frequent when using hot tonsillectomy techniques (although some studies do not suggest so). A negative history of hemorrhagic disorders is the most important factor for prediction of non-surgical bleeding. There is a greater risk of bleeding in adult patients and males. Indication of tonsillectomy seems not to influence the bleeding frequency. First postoperative bleeding increases the risk of subsequent, more serious bleeding approximately twice. The risk is also increased when using certain medications (e.g. aspirin). The influence of surgeon’s experience is not clear.
Rarely, the post-tonsillectomy bleeding can be life-threatening. There is a lack of exact data on their incidence because there is no systematic monitoring of these events. Despite of all the measures that can be taken it is not always possible to prevent the death of the patient or severe neurological consequences (due to cardiac arrest and resuscitation).
At the conclusion of the paper, there is a summary of basic measures necessary for treatment of both nonsevere and severe post-tonsillectomy bleeding.
Keywords:
tonsillectomy, bleeding, life-threatening bleeding, incidence, factors influencing the bleeding, treatment measures for bleeding
Zdroje
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Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2014 Číslo 1
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