Does more than a single chest tube for mediastinal drainage affect outcomes after cardiac surgery?

Le, Jeffrey; Buth, Karen J.; Hirsch, Gregory M.; Légaré, Jean‐François

doi:10.1503/cjs.006814

Cited by 14 publications

(11 citation statements)

References 12 publications

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“…Hence we infer from our study ( Table 2) that having 2 mediastinal drains does not provide any advantage with respect to reduction in re-exploration rates, perioperative mortality, early mobilization and reduced hospital stay over the use of a single mediastinal drain. This corroborates with the findings of Légaré et al 6 We also noted that having more than 1 mediastinal drain was a source of increased postoperative pain leading to higher analgesia requirement.…”

Section: Discussionsupporting

confidence: 92%

Do we need more than one mediastinal drain in cardiac surgery?

Bansal

Guha

Sharma³

et al. 2019

Int Surg J

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Background: Placement of mediastinal drains after cardiac surgery is standard of care. However, there is no consensus over the number of drains to be placed. Is there any advantage of multiple drains over a single drain? This question formed the premise of this study. Methods: All consecutive patients operated between 2014 and 2015 were included. Those with pleural drains were excluded. Patients had either a single drain in the pericardial cavity or had two drains, one in the pericardial and the other in retrostenal area. A total of 244 patients were included in the study group. Results: Out of 244 patients, 122 had single drain and 122 had 2 mediastinal drains. The mean age was 24.38±17.08 (Age range 6 months to 66 years) and male: female ratio was 1.5:1. There was no statistically significant difference in single drain vs double drain group in terms of the number of days of drainage (1.65 vs 1.55, p 0.325), time to mobilize (36.57 vs 35.23 hours, p=0.684), ICU stay (2.62 vs 2.63 days, p=0.96)and re-exploration (5.7%, vs 9.8%, p=0.34). However, patients with two mediastinal drains had higher requirement of analgesia (p=0.004). Conclusions: The use of two mediastinal drains does not confer any advantage over a single mediastinal drain after cardiac surgery in assessing or controlling bleed or recovery. However, the post-operative pain is significantly higher with use of two mediastinal drains.

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Section: Discussionsupporting

confidence: 92%

Do we need more than one mediastinal drain in cardiac surgery?

Bansal

Guha

Sharma³

et al. 2019

Int Surg J

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“…In thoracic surgery, it is performed to swell the collapsed lungs again, and the major indication is pneumothorax (7). In cardiac surgery, as a standard part of care, chest tubes are inserted in order to drain the serosanguinous fluid through the mediastinal or pleural cavity for the purpose of preventing complications such as cardiac tamponade (8). In the present study, the reason for the insertion of a chest tube into the pleural cavity is better known than that for the insertion of a chest tube into the mediastinal cavity, which can be attributed to the fact that the study was conducted in a hospital dealing with chest diseases.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Knowledge Levels of Chest Drain Management: A Descriptive Study

Tarhan¹,

Gökduman²,

Ayan³

et al. 2017

Eurasian J Pulmonol

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“…The findings of the present study indicated that the number of chest tubes is one of the factors associated with increased ICU LOS after cardiac surgery. Lee et al [ 15 ] found that there was no difference between placing a chest drainage tube after cardiac surgery and more than one in terms of postoperative complications and its consequences. Our finding is inconsistent with the results of that study.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Length of Stay in Intensive Care Unit after Coronary Artery Bypass Grafting: Development a Risk Scoring System

Zarrizi

Paryad

Khanghah

et al. 2021

Braz J Cardiovasc Surg

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Introduction To determine predictors of length of stay (LOS) in the intensive care unit (ICU) after coronary artery bypass grafting (CABG) and to develop a risk scoring system were the objectives of this study. Methods In this retrospective study, 1202 patients' medical records after CABG were evaluated by a research-made checklist. Tarone-Ware test was used to determine the predictors of patients' LOS in the ICU. Cox regression model was used to determine the risk factors and risk ratios associated with ICU LOS. Results The mean ICU LOS after CABG was 55.27±17.33 hours. Cox regression model showed that having more than two chest tubes (95% confidence interval [CI] 1.005-1.287, Relative Risk [RR]=1.138), occurrence of atelectasis (95% CI 1.000-3.007, RR=1.734), and occurrence of atrial fibrillation after CABG (95% CI 1.428-2.424, RR=1.861) were risk factors associated with longer ICU LOS. The discrimination power of this set of predictors was demonstrated with an area under the receiver operating characteristic curve and it was 0.69. A simple risk scoring system was developed based on three identified predictors that can raise ICU LOS. Conclusion The simple risk scoring system developed based on three identified predictors can help to plan more accurately a patient's LOS in hospital for CABG and can be useful in managing human and financial resources.

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Does more than a single chest tube for mediastinal drainage affect outcomes after cardiac surgery?

Cited by 14 publications

References 12 publications

Do we need more than one mediastinal drain in cardiac surgery?

Do we need more than one mediastinal drain in cardiac surgery?

Nurses’ Knowledge Levels of Chest Drain Management: A Descriptive Study

Predictors of Length of Stay in Intensive Care Unit after Coronary Artery Bypass Grafting: Development a Risk Scoring System

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