BACKGROUND: The use of 1 or more mediastinal chest tubes has traditionally been routine for all cardiac surgery procedures to deal with bleeding. However, it remains unproven whether multiple chest tubes offer a benefit over a single chest tube. METHODS: All consecutive patients undergoing cardiac surgery (2005-2010) received at least 1 chest tube at the time of surgery based on surgeon preference. Patients were grouped into those receiving a single chest tube (SCT) and those receiving multiple chest tubes (MCT). The primary outcome was return to the operating room for bleeding or tamponade. RESULTS: A total of 5698 consecutive patients were assigned to 2 groups: 3045 to the SCT and 2653 to the MCT group. Patients in the SCT group were older, more often female and less likely to undergo isolated coronary artery bypass graft than those in the MCT group. Unadjusted outcomes for SCT and MCT, respectively, were return to the operating room for bleeding or tamponade (4.7% v. 5.0%; p = 0.50), intensive care unit stay longer than 48 hours (25.5% v. 27.9%; p = 0.041, postoperative stay > 9 days (31.5% v. 33.1%; p = 0.20) and mortality (3.8% v. 4.6%; p = 0.16). Logistic regression analysis, adjusted for clinical differences between groups, showed that the number of chest tubes was not associated with return to the operating room for bleeding or tamponade. CONCLUSION: The use of multiple mediastinal chest tubes after cardiac surgery confers no advantage over a single chest tube in preventing return to the operating room for bleeding or tamponade.
BACKGROUND: The use of 1 or more mediastinal chest tubes has traditionally been routine for all cardiac surgery procedures to deal with bleeding. However, it remains unproven whether multiple chest tubes offer a benefit over a single chest tube. METHODS: All consecutive patients undergoing cardiac surgery (2005-2010) received at least 1 chest tube at the time of surgery based on surgeon preference. Patients were grouped into those receiving a single chest tube (SCT) and those receiving multiple chest tubes (MCT). The primary outcome was return to the operating room for bleeding or tamponade. RESULTS: A total of 5698 consecutive patients were assigned to 2 groups: 3045 to the SCT and 2653 to the MCT group. Patients in the SCT group were older, more often female and less likely to undergo isolated coronary artery bypass graft than those in the MCT group. Unadjusted outcomes for SCT and MCT, respectively, were return to the operating room for bleeding or tamponade (4.7% v. 5.0%; p = 0.50), intensive care unit stay longer than 48 hours (25.5% v. 27.9%; p = 0.041, postoperative stay > 9 days (31.5% v. 33.1%; p = 0.20) and mortality (3.8% v. 4.6%; p = 0.16). Logistic regression analysis, adjusted for clinical differences between groups, showed that the number of chest tubes was not associated with return to the operating room for bleeding or tamponade. CONCLUSION: The use of multiple mediastinal chest tubes after cardiac surgery confers no advantage over a single chest tube in preventing return to the operating room for bleeding or tamponade.
Authors: Maria Akrofi; Scott Miller; Steve Colfar; Peter R Corry; Brian M Fabri; Mark D Pullan; Glenn N Russell; Mark A Fox Journal: Anesth Analg Date: 2005-01 Impact factor: 5.108
Authors: X M Mueller; F Tinguely; H T Tevaearai; P Ravussin; F Stumpe; L K von Segesser Journal: Eur J Cardiothorac Surg Date: 2000-11 Impact factor: 4.191
Authors: Rakesh C Arora; Jean-Francois Légaré; Karen J Buth; John A Sullivan; Gregory M Hirsch Journal: Ann Thorac Surg Date: 2004-11 Impact factor: 4.330
Authors: Shanaz Shalli; Diyar Saeed; Kiyotaka Fukamachi; A Marc Gillinov; William E Cohn; Louis P Perrault; Edward M Boyle Journal: J Card Surg Date: 2009 Sep-Oct Impact factor: 1.620
Authors: Johan S J Manshanden; Chantal L I Gielen; Corianne A J M de Borgie; Robert J M Klautz; Bas A J M de Mol; David R Koolbergen Journal: EBioMedicine Date: 2015-07-31 Impact factor: 8.143
Authors: Débora Santos de Oliveira Gomes; Elzane Jesus de Almeida Silva; Josimar Silva E Silva; Hayssa de Cássia Mascarenhas Barbosa; André Raimundo Guimarães; André Luiz Lisboa Cordeiro Journal: Braz J Anesthesiol Date: 2021-07-05