Is routine chest X-ray following mediastinal drain removal after cardiac surgery useful?

Khan, Tanveer A.; Chawla, Girish; Daniel, Romany; Swamy, M. S. Mallikarjuna; Dimitri, Wade R.

doi:10.1016/j.ejcts.2008.05.002

Cited by 26 publications

(36 citation statements)

References 7 publications

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“…In the present study, as opposed to hypertension that had no relationship with postoperative atelectasis, there was a significant relationship between hyperlipidemia and postoperative atelectasis (p≤0.000) because 44.1% out of 60 patients with diabetes and 40% out of 82 patients with hyperlipidemia faced with postoperative atelectasis. This finding is in line with that of the study conducted by Tanveer et al ( Khan et al, 2008 ).…”

Section: Discussionsupporting

confidence: 94%

“…Where these lines were observed in different parts of lung and they were not specific to a single part, the atelectasis was linear. When the lines were limited to the fissures between the lung lobes and did not cause the fissures to move, it was called segmental atelectasis, and if the lines caused the fissures to move toward mediastinum, heart, and endotracheal tube, it was considered as lobar atelectasis ( Khan et al, 2008 ). The collected data were fed to SPSS 16.0.…”

Section: Methodsmentioning

confidence: 99%

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Frequency Rate of Atelectasis in Patients Following Coronary Artery Bypass Graft and Its Associated Factors at Mazandaran Heart Center in 2013-2014

Saffari¹,

Nasiri²,

Mousavinasab³

et al. 2015

GJHS

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Introduction:As the most common postoperative pulmonary complications after cardiac surgery, atelectasis is one of the most important and serious early postoperative complications and one of the most important causes of prolonged hospitalization, increased costs, and mortality rise. Therefore, the present study was aimed at specifying the frequency of atelectasis in patients following coronary artery bypass graft and its associated factors in Mazandaran Heart Center in 2013-2014.Materials:The present investigation was a descriptive cross-sectional study in which sequential sampling was used. It was conducted on 375 patients whose coronary artery bypass graft had been performed by the same surgeon and anesthesiologist. For data collection, first the patients’ demographic variables and the information of their surgery were retrieved through their profiles, direct observation, patient inquiry, and the collected data were recorded in the data collection forms. Then, atelectasis was measured before the surgery and on the first and second days after it by taking CXR whose results were checked by two radiologists who were not aware of the previous observations. Data were analyzed through t-test, Pearson test, and Chi-square test using SPSS 16.0.Results:The results of the present study indicated that, 123 out of 375 patients (32.8%) were diagnosed with at least one type of tattletales during the first three days after the surgery. The mean age of the patients who were diagnosed with atelectasis was 62.9 and most of them were female. The results also showed that there was a significant relationship between postoperative frequency of atelectasis and the patients’ pulmonary diseases and underlying diseases like diabetes and hyperlipidemia, smoking and alcohol use before the surgery, and transfusion of 4 units of packed red blood cells during the surgery (p<0.05).Conclusion:Atelectasis is the most common postoperative complication which emerges more in patients with pulmonary and underlying diseases than other patients.

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Section: Discussionsupporting

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Frequency Rate of Atelectasis in Patients Following Coronary Artery Bypass Graft and Its Associated Factors at Mazandaran Heart Center in 2013-2014

Saffari¹,

Nasiri²,

Mousavinasab³

et al. 2015

GJHS

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show abstract

“…[13][14][15][16][17][18][19][20][21] The diagnostic and therapeutic efficacy of all these routine CXRs has been reported to be low. [1][2][3][6][7][8][9]11,13,14,[16][17][18][19]21 Investigators comparing a routine CXR strategy with an on-demand CXR strategy were not able to show any difference in outcome measures. [22][23][24][25][26][27][28] Although those studies indicated that a more restrictive CXR strategy should be safe, a more recent meta-analysis by Ganapathy and colleagues 26 stated that, in those studies, the confidence intervals were wide, and the study populations were small.…”

Section: See Editorial Commentary Page 230mentioning

confidence: 99%

“…Multiple investigators have studied the clinical value of routine CXRs after central venous catheterization, endotracheal intubation, and chest tube placement or removal. [1][2][3][4][5][6][7][8][9][10][11][12] Others have studied the value of daily routine CXRs in a mixed ICU population, or in mechanically ventilated patients only. [13][14][15][16][17][18][19][20][21] The diagnostic and therapeutic efficacy of all these routine CXRs has been reported to be low.…”

Section: See Editorial Commentary Page 230mentioning

confidence: 99%

Defining indications for selective chest radiography in the first 24 hours after cardiac surgery

Tolsma

Rijpstra

Rosseel

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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“…Multiple investigators have studied the clinical value of routine CXRs following central venous catheterization, endotracheal intubation and chest tube placement or removal [ 1 ]-[ 12 ]. Others have studied the value of daily routine CXRs in a mixed ICU population or in mechanically ventilated patients only [ 13 ]-[ 22 ] The diagnostic and therapeutic efficacy of these routine CXRs is known to be low [ 1 ]-[ 3 ],[ 6 ]-[ 9 ],[ 11 ],[ 13 ],[ 14 ],[ 16 ]-[ 19 ],[ 22 ]. Investigators comparing a routine CXR strategy with an on-demand CXR strategy were not able to show any difference in outcome measures [ 23 ]-[ 29 ], but a more recent meta-analysis by Ganapathy et al indicated that study populations were small and that eventually missed findings in a restrictive strategy were not evaluated frequently enough [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

The value of routine chest radiographs after minimally invasive cardiac surgery: an observational cohort study

Tolsma

Bentala

Rosseel

et al. 2014

J Cardiothorac Surg

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BackgroundChest radiographs (CXRs) are obtained frequently in postoperative cardiac surgery patients. The diagnostic and therapeutic efficacy of routine CXRs is known to be low and the discussion regarding the safety of abandoning these CXRs after cardiac surgery is still ongoing. We investigated the value of routine CXRs directly after minimally invasive cardiac surgery.MethodsWe prospectively included all patients who underwent minimally invasive cardiac surgery by port access, ministernotomy or bilateral video-assisted thoracoscopy (VATS) in the year 2012. A direct postoperative CXR was performed on all patients at ICU arrival. All CXR findings were noted, including whether they led to an intervention or not. The results were compared to the postoperative CXR results in patients who underwent conventional cardiac surgery by full median sternotomy over the same period.Main resultsA total of 249 consecutive patients were included. Most of these patients underwent valve surgery, rhythm surgery or a combination of both. The diagnostic efficacy for minor findings was highest in the port access and bilateral VATS groups (56% and 63% versus 28% and 45%) (p < 0.005). The diagnostic efficacy for major findings was also higher in these groups (8.9% and 11% versus 4.3% and 3.8%) (p = 0.010). The need for an intervention was most common after minimally invasive surgery by port access, although this difference was not statistically significant (p = 0.056).ConclusionsThe diagnostic efficacy of routine CXRs performed after minimally invasive cardiac surgery by port access or bilateral VATS is higher than the efficacy of CXRs performed after conventional cardiac surgery. A routine CXR after these procedures should still be considered.

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Is routine chest X-ray following mediastinal drain removal after cardiac surgery useful?

Cited by 26 publications

References 7 publications

Frequency Rate of Atelectasis in Patients Following Coronary Artery Bypass Graft and Its Associated Factors at Mazandaran Heart Center in 2013-2014

Frequency Rate of Atelectasis in Patients Following Coronary Artery Bypass Graft and Its Associated Factors at Mazandaran Heart Center in 2013-2014

Defining indications for selective chest radiography in the first 24 hours after cardiac surgery

The value of routine chest radiographs after minimally invasive cardiac surgery: an observational cohort study

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