&lt;![CDATA[&lt;b&gt;Effects of the pleural drain site on the pulmonary function after coronary artery bypass graf&lt;/b&gt;]]&gt;

Guizilini, Solange; Gomes, Walter J.; Faresin, Sônia Maria; Carvalho, Antônio Carlos Camargo; Jaramillo, Javier Tamayo; Alves, Flávia dos S; Catani, Roberto; Buffolo, Ênio

doi:10.1590/s1678-97412004000100010

Cited by 14 publications

(30 citation statements)

References 14 publications

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“…In our study, the tube was placed under direct vision before chest closure, ensuring the proper positioning. Analyzing the painful effects, Guizilini states that intercostal chest tube placement increases postoperative pain, with restriction of deep breathing, coughing, and changing patient's position on the bed 10 , findings that are consistent with our results.…”

Section: Momentsupporting

confidence: 91%

“…Guizilini et al 10 conducted a similar study, but in patients without CPB, and found results similar to ours, although they did not study the immediate effect of chest tube removal 10 .…”

Section: Momentsupporting

confidence: 73%

“…Guizilini et al studied the effect of pleural drain site of insertion on postoperative lung function in coronary artery bypass grafting and found that, regardless of drain positioning, pain and loss of lung function occurred, although the effects were less noticeable when the drain was placed in the subxiphoid region 10 . Chest tubes are made from various raw materials and all seem to work satisfactorily regarding blood drainage from the pleural space and the pain of withdrawal procedure 11 .…”

Section: Introductionmentioning

confidence: 99%

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Influência da posição do dreno pleural na função pulmonar de pacientes submetidos à revascularização do miocárdio

Vieira¹,

Vieira²,

Abrão

et al. 2012

Rev. Bras. Anestesiol.

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Summary: Ozelami Vieira IBC, Vieira FF, Abrão J, Gastaldi AC -Influence of Pleural Drain Insertion in Lung Function of Patients Undergoing Coronary Artery Bypass Grafting. Background and objectives:Longitudinal, prospective, randomized, blinded Trial to assess the influence of pleural drain (non-toxic PVC) site of insertion on lung function and postoperative pain of patients undergoing coronary artery bypass grafting in the first three days post-surgery and immediately after chest tube removal.

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Section: Momentsupporting

confidence: 91%

“…Guizilini et al 10 conducted a similar study, but in patients without CPB, and found results similar to ours, although they did not study the immediate effect of chest tube removal 10 .…”

Section: Momentsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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Influência da posição do dreno pleural na função pulmonar de pacientes submetidos à revascularização do miocárdio

Vieira¹,

Vieira²,

Abrão

et al. 2012

Rev. Bras. Anestesiol.

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“…Additionally, contemporary evidence suggests that shifting the site of pleural drain insertion to the subxyphoid position minimizes chest wall trauma and preserves respiratory function in the early postoperative period [8,9]. …”

Section: Introductionmentioning

confidence: 99%

Pleurotomy with subxyphoid pleural drain affords similar effects to pleural integrity in pulmonary function after off-pump coronary artery bypass graft

Guizilini

Bolzan

Faresin

et al. 2012

J Cardiothorac Surg

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BackgroundExacerbation of pulmonary dysfunction has been reported in patients receiving a pleural drain inserted through the intercostal space in comparison to patients with an intact pleura undergoing coronary artery bypass grafting (CABG). Evidence suggests that shifting the site of pleural drain insertion to the subxyphoid position minimizes chest wall trauma and preserves respiratory function in the early postoperative period. The aim of this study was to compare the pulmonary function parameters, clinical outcomes, and pain score between patients undergoing pleurotomy with pleural drain placed in the subxyphoid position and patients with intact pleural cavity after off-pump CABG (OPCAB) using left internal thoracic artery (LITA).MethodsSeventy-one patients were allocated into two groups: I (n = 38 open left pleural cavity and pleural drain inserted in the subxyphoid position); II (n = 33 intact pleural cavity). Pulmonary function tests and clinical parameters were recorded preoperatively and on postoperative days (POD) 1, 3 and 5. Arterial blood gas analysis and shunt fraction were evaluated preoperatively and in POD1. Pain score was assessed on POD1. To monitor pleural effusion and atelectasis chest radiography was performed routinely 1 day before operation and until POD5.ResultsIn both groups a significant impairment was found in lung function parameters until on POD5. However, no significant difference in forced vital capacity and forced expiratory volume in 1 second were seen between groups. A significant decrease in partial pressure of arterial oxygen and an increase in shunt fraction values were observed on POD1 in both groups, but no statistical difference was found when the groups were compared. Pleural effusion and atelectasis until on POD5 were similar in both groups. There were no statistical differences in pain score, duration of mechanical ventilation and postoperative hospital stay between groups.ConclusionSubxyphoid insertion of pleural drain provides similar effects to preserved pleural integrity in pulmonary function, clinical outcomes, and thoracic pain after OPCAB. Therefore, our results support the hypothesis that once pleural cavities are incidentally or purposely opened during LITA dissection, subxyphoid placement of the pleural drain is recommended.

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“…The insertion of an intercostal pleural drain causes additional injury to the thorax, as it becomes necessary to perforate intercostal muscles and the parietal pleura, which also interferes with respiratory movements. Consequently, the location of the pleural drain might have an influence on the discomfort suffered by the patient and on the degree of alteration of pulmonary function 5. Previous studies have examined the efficiency of pleural drainage with different methods, such as daily chest x-rays (CXRs),5–7 thoracic ultrasonography (USG)7 and echocardiography (ECHO);48 however, no study has demonstrated reliably that any means of pleural drainage is superior.…”

mentioning

confidence: 99%

Computed tomography evaluation of different chest tube sites for residual pleural volumes after coronary artery bypass surgery

Sensoz

Günay

Tuygun

et al. 2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVES:We investigated the efficacy of pleural drainage with the use of different chest tube methods in patients after coronary artery bypass graft (CABG) surgery.DESIGN AND SETTING:Prospective randomized study of 60 patients undergoing elective on-pump single CABG surgery.PATIENTS AND METHODS:The left internal mammary arterial grafts were harvested from all patients. The patients were separated into three groups: In one group (IC6, n=20), pleural tubes were inserted through the sixth intercostal space at the midaxillary line; in the second group (SX-r, n=20), rigid straight pleural tubes were inserted from the mediastinum through the subxiphoid area; and in the third group (SX-s, n=20), soft curved drainage tubes were inserted from the mediastinum through the subxiphoid area. The residual pleural effusion was examined by multislice CT scans within 8 hours of removal of the drainage tubes. Pain was evaluated according to standard methods.RESULTS:The groups did not differ with respect to volume of residual pleural effusion (P>.05). The IC6 group had a higher mean pain score than the other two groups (P<.05), whose mean pain scores did not differ significantly from each other (P>.05). IC6 group patients had a higher requirement for analgesics. The rate of atelectasis was higher in group IC6 (P<.05).CONCLUSION:CT scans revealed that different chest tube insertion sites have the same efficiency for draining of pleural effusion, although drainage tubes inserted through the thoracic cage may result in more severe pain.

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

Cited by 14 publications

References 14 publications

Influência da posição do dreno pleural na função pulmonar de pacientes submetidos à revascularização do miocárdio

Influência da posição do dreno pleural na função pulmonar de pacientes submetidos à revascularização do miocárdio

Pleurotomy with subxyphoid pleural drain affords similar effects to pleural integrity in pulmonary function after off-pump coronary artery bypass graft

Computed tomography evaluation of different chest tube sites for residual pleural volumes after coronary artery bypass surgery

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