Site of Pleural Drain Insertion and Early Postoperative Pulmonary Function Following Coronary Artery Bypass Grafting With Internal Mammary Artery

Hagl, Christian; Harringer, Wolfgang; Gohrbandt, Bernhard; Haverich, Axel

doi:10.1378/chest.115.3.757

Cited by 41 publications

(62 citation statements)

References 12 publications

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“…A similar result was found by HAGL et al [13], in a study of patients submitted to CABG surgery using CPB with the use of LITA grafts, where the drains were inserted in the intercostal region or the subxiphoid region. In this study, although the differences remained significant when comparing the values on the 5 th postoperative day, the MI group presented a mean FVC of 78.22% in relation to the preoperative period, but the upper limit reached 100%, while in the LI group, the upper limit was only 70%.…”

Section: Discussionsupporting

confidence: 85%

“…Similar results were described by RIEBMAN et al [21], who described the technique of insertion of the pleural drain in the subxiphoid region, aiming at reducing the postoperative discomfort caused by friction of the drain in the intercostal space. Hagl et al [13] also showed that the pain in patients with subxiphoid implantation of the pleural drain was less when compared to intercostal insertion.…”

Section: Discussionmentioning

confidence: 99%

“…In this study and discussion, the pleural drains of the patients, independent of their position, were removed on the 2 nd postoperative day and there was no necessity of additional thoracocentesis, thus the drains were efficacious. This result is justified by the correct positioning of the end of the subxiphoid curved drain in the left costophrenic sinus [4,13,21], as was demonstrated by postoperative thoracic radiography.…”

Section: Discussionmentioning

confidence: 99%

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<![CDATA[<b>Effects of the pleural drain site on the pulmonary function after coronary artery bypass graf</b>]]>

Guizilini¹,

Gomes²,

Faresin³

et al. 2004

Braz. j. cardiovasc. surg.

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Objective: To analyze pulmonary functional changes and pain in patients undergoing off-pump coronary artery bypass grafting utilizing a left internal thoracic artery graft, comparing pleural drain insertion through the intercostal space and the subxyphoid approach.Methods: Twenty-eight patients (mean age 57.4 ± ± ± ± ± 8.4 years) were divided into two groups, according to the pleural drain site. Group LI (n=15) had the pleural drain inserted through the sixth left intercostal space at the mid-axillary line and in the MI group (n=13) the drain was placed through the subxyphoid region. All the patients underwent pre-and postoperative evaluations of pulmonary function tests as well as arterial blood gas analysis. Forced vital capacity (FVC) and forced expiratory volume over one second (FEV 1 ) were recorded in the preoperative period, and on the first, third and fifth postoperative days. The pain sensation was evaluated using a standard score from 0 to 10. Results:In both groups, falls in the FVC and FEV 1 were noted, up to the fifth postoperative day (P<0.001). However the decrease was higher in the LI group, when compared to the MI group (p<0.05). Also arterial blood gas analysis showed a decline of the partial oxygen pressure in both groups on the first postoperative day, but more significantly in the LI group (p=0.021). The pain sensation was higher in the LI group (p=0.002).Conclusion: Off-pump coronary artery bypass grafting using the left internal thoracic artery, disregarding the pleural drain site, leads to a significant decrease of postoperative pulmonary function. However, the subxyphoid technique of drain insertion has shown a better preservation of the lung function when compared to the intercostal drain site.Descriptors: Coronary artery bypass surgery. Pleural drain. Pulmonary function. 48GUIZILINI, S ET AL -Effects of the pleural drain site on the pulmonary function after coronary artery bypass grafting Bras Cir Cardiovasc 2004; 19(1): 47-54 Rev

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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<![CDATA[<b>Effects of the pleural drain site on the pulmonary function after coronary artery bypass graf</b>]]>

Guizilini¹,

Gomes²,

Faresin³

et al. 2004

Braz. j. cardiovasc. surg.

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“…Cerrahi ve anestezi birlikte vital kapasitede, total akciğer kapasitesinde ve fonksiyonel reziduel kapasitede % 40'a varan azalma gibi bazı solunumsal değişikliler yapar (33,34) . Biz de uzamış anestezi süresi ile solunum kompilkasyonlarının arasında anlamlı bir ilişki tespit etmiş olsak da bunu etkileyen cerrahi ekibin deneyiminden, yapılan ameliyatın tipinden, hastanın anatomik ve fiziksel özelliklerinden tamamen ayrılmasını olası değildir.…”

Section: Discussionunclassified

Preoperative, İntraoperative and Postoperative Predictors of Postoperative Respiratory System Complications in Patients Undergoing Open Heart Surgery

Sargın¹,

Aşkar²,

Kocabas³

2014

GKDA Derg

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“…The shift of pleural drain site from intercostal to the subxyphoid position might interfere in the degree of lung volumes commitment and capacities in the early CABG postoperative. Previous studies demonstrated that, independently of CPB use, drain insertion in the subxyphoid region is able to afford better preservation of spirometric parameters in the CABG postoperative period when compared to the intercostal region [3,4].…”

Section: Introductionmentioning

confidence: 99%

Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea

Cancio¹,

Guizilini²,

Bolzan³

et al. 2012

Rev Bras Cir Cardiovasc

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Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea: estudo controlado randomizado Subxyphoid pleural drain confers lesser impairment in respiratory muscle strength, oxygenation and lower chest pain after off-pump coronary artery bypass grafting: a randomized controlled trial Abstract Objective: To evaluate respiratory muscle strength, oxygenation and chest pain in patients undergoing off-pump coronary artery bypass (OPCAB) using internal thoracic artery grafts comparing pleural drain insertion site at the subxyphoid region versus the lateral region.Methods: Forty patients were randomized into two groups in accordance with the pleural drain site. Group II (n = 19) -pleural drain exteriorized in the intercostal space; group (SI) (n = 21) chest tube exteriorized at the subxyphoid region. All patients underwent assessment of respiratory muscle strength (inspiratory and expiratory) on the pre, 1, 3 and 5 postoperative days (POD). Arterial blood gas analysis was collected on the pre and POD1. The chest pain sensation was measured 1, 3 and 5 POD.Results: A significant decrease in respiratory muscle strength (inspiratory and expiratory) was seen in both groups until POD5 (P <0.05). When compared, the difference between groups remained significant with greater decrease in the II (P <0.05). The blood arterial oxygenation fell in both groups (P <0.05), but the oxygenation was lower in the II (P <0.05). Referred chest pain was higher 1, 3 and 5 POD in the II group (P <0.05). The orotracheal intubation time and postoperative length of hospital stay were higher in the II group (P <0.05).Conclusion: Patients submitted to subxyphoid pleural drainage showed less decrease in respiratory muscle strength, better preservation of blood oxygenation and reduced thoracic pain compared to patients with intercostal drain on early OPCAB postoperative. 104Cancio ASA, et al. -Subxyphoid pleural drain confers lesser impairment in respiratory muscle strength, oxygenation and lower chest pain after off-pump coronary artery bypass grafting: a randomized controlled trial Bras Cir Cardiovasc 2012;27(1):103-9 Rev

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Site of Pleural Drain Insertion and Early Postoperative Pulmonary Function Following Coronary Artery Bypass Grafting With Internal Mammary Artery

Cited by 41 publications

References 12 publications

<![CDATA[<b>Effects of the pleural drain site on the pulmonary function after coronary artery bypass graf</b>]]>

<![CDATA[<b>Effects of the pleural drain site on the pulmonary function after coronary artery bypass graf</b>]]>

Preoperative, İntraoperative and Postoperative Predictors of Postoperative Respiratory System Complications in Patients Undergoing Open Heart Surgery

Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea

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