Withdrawal of chest tubes without water seal vs. negative continuous suction after closed cardiovascular surgery procedures in children

Heladia Josefa García; Ricardo Villalpando-Canchola; Luis Ramírez-Meléndez; Octavio Herrera-Verdugo; Joaquín Rodolfo Zepeda-Sanabria; Mario Franco-Gutiérrez; Carlos David González-Lara

2006, Number 4

Cir Cir 2006; 74 (4)

Withdrawal of chest tubes without water seal vs. negative continuous suction after closed cardiovascular surgery procedures in children

García HJ, Villalpando-Canchola R, Ramírez-Meléndez L, Herrera-Verdugo O, Zepeda-Sanabria JR, Franco-Gutiérrez M, González-Lara CD

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Language: Spanish
References: 19
Page: 237-242
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ABSTRACT

Objective: We undertook this study to compare the frequency and type of complications, as well as the length of hospital stay, in children who underwent closed cardiovascular surgery with chest tube drainage during the postsurgical period with children in whom the drainage was withdrawal with continuous suction, once thoracotomy was completed.
Methods: A retrospective, descriptive and analytic study was performed at the IMSS Hospital de Pediatria, located at the XXI Century National Medical Center in Mexico City. Eighty eight children who underwent closed cardiovascular surgery (Group I) without chest tubes and 42 with chest tubes (Group II) were studied.
Results: In Group I the frequency of complications was 27.3% and in group II 59.5%. Complications were as follows: subcutaneous emphysema was seen in 13.6% (n = 12) of group I and in 45.2% (n = 19) of group II (p = 0.0001); pneumothorax in 13.6% (n = 12) vs. 28.6% (n = 12), p = 0.04; and chylothorax in 2.3% (n = 2) vs. 2.4% (n = 1), p = 1.0, respectively. The median time of hospital stay in group I was 3 days and in group II was 6 days (p = 0.0001).
Conclusions: In children, in some closed cardiovascular surgeries, withdrawal of chest tube drainage with negative suction when thoracotomy is completed may decrease the frequency of pneumothorax, subcutaneous emphysema and length of hospital stay, in comparison with patients in whom chest tube drainage is left during the postoperative period.

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