Effect of Timing of Chest Tube Removal on Development of Pericardial Effusion Following Cardiac Surgery

Abstract

It is safe to remove the chest tubes as soon as the macroscopic appearance of the drainage fluid turns to serosanguineous since this practically indicates cessation of active bleeding.

Delayed cardiac tamponade after open heart surgery - is supplemental CT imaging reasonable?

“…This indicates incidence of delayed cardiac tamponade not being affected by late removal of chest tubes. As described previously, prolonged chest tube drainage does not impact incidence of pericardial effusion [8,9]. Due to patients’ discomfort, the authors’ institutional policy implicates tube removal on postoperative day one, if drain volume is less than 400 mL without increased incidence of pericardial effusion evident.…”

High-vacuum drains rival conventional underwater-seal drains after pediatric heart surgery

“…Small and usually insignificant pleural and pericardial effusions develop in over 50% of patients undergoing cardiac surgery [7][8][9]11,12]. Near complete evacuation of postoperative mediastinal fluid and/or air is imperative in the pediatric population because of the smaller volumes required for hemodynamic compromise.…”

“…The reported rate of pericardial/pleural effusions (evident on echocardiography) following pediatric and adult open-heart surgery is O50% [7][8][9]. There are no reports with regard to the incidence of re-operation (drainage) in this setting.…”

Incidence and factors associated with pericardial effusion after cardiac valve surgery

“…Most of our patients had their chest drainage removed on the second postoperative day. Some authors showed that there is no difference between early (< 24 hours) and late (≥ 24 hours) chest tube removal 20,21 . Chest tube withdrawal delay would increase the risk of infection and would cause more discomfort to patients 22,23 , but its early removal could predispose to the development of PE 24 .…”