Re-exploration for bleeding associated with increased incidence of the need for reintervention after coronary artery bypass graft surgery

Dimberg, Axel; Alström, Ulrica; Janiec, Mikael

doi:10.1093/icvts/ivy245

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Associated with an increased postoperative complication rate and mortality, chest re-exploration in the early postoperative phase is a possible event of patients undergoing cardiac surgery. Consistent with current literature (22,23), our results showed re-thoracotomy rates of 5.3% and 2.2%, respectively. Without reaching significance, we could demonstrate a 3.3-percent reduction in the re-thoracotomy rate when the digital drainage system was used.…”

Section: Discussionsupporting

confidence: 93%

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

et al. 2019

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Background: Thoracic chest drains are placed after cardiac surgery allowing for the clearance of blood, fluid, and air to prevent post-operative complications. Despite its importance, there is little data on the application of digital chest drainage systems in cardiac surgery. Therefore, the differences between an analog and a digital chest drainage system in cardiac surgery patients were investigated in a randomized controlled trial. Methods: A total of 354 elective cardiac surgery patients were preoperatively randomized 1:1 between September 2016 and September 2017 to either an analog (Ocean) or a digital (Thopaz + ) chest drainage system aiming to compare drainage-associated postoperative outcome parameters.Results: A total of 340 patients were included in the analysis (analog: 188; digital: 152) with no significant differences in preoperative baseline parameters. Incidence of X-rays to detect air leaks was significantly lower in the digital group (analog: 20.2%; digital: 8.6%; P<0.01). Patients treated with the digital system showed a 3.3% reduction of re-thoracotomies, however, not statistically significant (analog: 5.3%; digital: 2.0%; P=0.19). Median total fluid amount did not significantly differ between study groups [median (P25; P75); analog: 705 (400; 1,333) mL; digital: 686 (404; 1,229) mL; P=0.83]; however, the use of the digital drainage system resulted in a quicker removal with a reduced median drainage duration of 16 hours (analog: 65 hours; digital: 49 hours; P≤0.01). Conclusions:The study provides evidence that digital drainage systems can be safely applied in cardiac surgery patients. The use of the digital management system led to a decreased incidence of drainageassociated complications as well as to shortened chest tube duration. Findings require confirmation by additional studies.

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Section: Discussionsupporting

confidence: 93%

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

et al. 2019

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“…Underweight patients have also been found to have high early mortality compared to overweight and obese patients. 6,7 Bleeding is a common complication after cardiac surgery. Cardiac surgeries are mostly performed with the use of cardiopulmonary bypass which induces a generalized inflammatory state, platelets dysfunction and coagulation factors dysfunction and dilution.…”

Section: Introductionmentioning

confidence: 99%

“…About 5% patients undergoing CABG are re-explored for bleeding. 8 Bleeding in the immediate postoperative period not only predisposes patients to complications like atrial fibrillation and wound infection but also the increased transfusion requirements as a result of bleeding increases the risks of graft failure and kidney injury. 9 Although increasing BMI has been associated with increased risk of acute kidney injury, increased ventilation time and ICU stay and significantly more chance of sternal wound complications, the effect of BMI on early postoperative mediastinal bleeding is less well described.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Body Mass Index on Bleeding After on Pump Coronary Artery Bypass Grafting

Siddiqeh

Khan²,

Fayyaz³

et al. 2022

PAFMJ

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Objective: To study the relationship of body mass index (BMI) and postoperative bleeding in patients undergoing isolated coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB). Study Design: Analytical cross sectional study Place and Duration of Study: Cardiothoracic services, Almana General Hospital, Al Khobar, Saudi Arabia, from Oct 2019 to Oct 2021. Methodology: Two hundred and twenty (220) consecutive patients who underwent CABG using cardiopulmonary bypass were included in the study. Patients who had additional procedures, those who were operated in emergency and those with significant comorbidities like hepatic and liver dysfunction were excluded from the final analysis. Patients were divided into three groups according to their BMI, healthy weight (BMI 18.5 to <25), overweight (BMI 25 to <30) and obese (BMI >30). The world health organization (WHO) definition was used to define different categories of BMI. Various perioperative variables were recorded for all the patients. Only the immediate postoperative follow up period was included in the study. Data was analyzed using IBM SPSS-statistics 23.0 (IBM, SPSS Inc., Chicago, IL). Results: Of the 220 patients included in the study, 184(83%) were male patients and 36(16%) female patients. There was no significant difference in the mean age of the patients in the three groups (p=0.481). There were significantly more hypertensive patients 46(45%) in the overweight group compared to other two groups (p=0.025). Baseline diabetic status was not significantly different among the three categories (p=0.978). Total mediastinal drainage in the first 24 hours was significantly less in the obese group (3.7±4.45 ml) compared to overweight (4.4±2.7 ml) and healthy weight (7.35±8.5 ml) patients (p=0.001). There was no mortality in the studied cohort. Conclusion: Bleeding after isolated coronary artery bypass grafting is inversely related to BMI. Patients with healthy and overweight BMI are at higher risk of bleeding compared to obese patients.

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Long-term Outcome of Reexploration for Bleeding After Coronary Artery Bypass Grafting

Stroo,

van Steenbergen,

van Straten

et al. 2023

Journal of Cardiothoracic and Vascular Anesthesia

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Re-exploration for bleeding associated with increased incidence of the need for reintervention after coronary artery bypass graft surgery

Abstract: Re-exploration for bleeding is associated with an increased risk for the need of repeat coronary reintervention during the first year after coronary artery bypass surgery.

Cited by 7 publications

References 20 publications

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

The Effect of Body Mass Index on Bleeding After on Pump Coronary Artery Bypass Grafting

Long-term Outcome of Reexploration for Bleeding After Coronary Artery Bypass Grafting

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