Comparison of Pleural and Pericardial Drainage with Medial or Lateral Thoracostomy Drain in Shariati Hospital in 1998-1999
نویسندگان
1 Associate Professor of Cardiac Surgery, Tehran University of Medical Sciences and Health Services, Shariatee Hospital, Tehran, Iran
2 Associate Professor of Cardiac Surgery, Tehran University of Medical Sciences and Health Services, Shariatee Hospital, Tehran, Iran
3 Assistant Professor of Endocrinology, Avesina Research Center, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
4 Assistant Professor of Cardiac Surgery, Iran University of Medical Sciences and Health Services, Shahid Rajaee Hospital, Tehran, Iran
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چکیده
Introduction & Objective: Complete drainage of fluid and blood from pericardial and pleural cavityafter cardiac surgery is very important because the residual blood, directly or indirectly, increases morbidity ormortality. The main goal of this study was to find the best method of pericardial and pleural drainage aftercardiac surgery.Materials & Methods: This study was performed in 415 patients undergoing open heart surgery inShariati Hospital between April 1998 and March 1999. Radiological findings and pericardial and pleuraleffusion in terms of the drain sites and in terms of posterior pericardiotomy (groups A, B, C and D) wereanalyzed and evaluated in these patients.Results: In 21.7% of the patients on the 3rd postoperative day, and in 17.9% of the patients on the 7thpostoperative day, pleural effusion was seen. The lateral drain with or without posterior pericardiotomysignificantly reduced pleural effusion on the 3rd (p-value = 0.02) and 7th (p-value=0.0001) postoperative daysin comparison with the median drain. Pericardial effusion in this study was 32.2%, whereas the drain site didnot affect pericardial effusion, posterior pericardiotomy affected and reduced pericardial effusion. There wassignificant difference (P-value = 0.0001) in terms of pericardial effusion between groups A, B, C and D.Conclusions: This study shows the better outcome of posterior pericardiotomy and lateral (direct)drainage of pleural cavity. In patients undergoing open heart surgery, if either of the pleural spaces is opened,we recommend that a drain be directly inserted into that space laterally and that posterior pericardiotomy bealso performed for them.
