Early chest tube removal after coronary artery bypass graft surgery

Mohsen Mirmohammad-Sadeghi, MD1, Ali Etesampour, MD2, Mojgan Gharipour, MSc3, Zeinab Shariat, MD4
Peyman Nilforoush, MD5, Mahmoud Saeidi, MD6, Mahsa Mackie, MD7, Fatemeh Mirmohamad Sadeghi MD8

1Assistant Professor of Cardiac Surgery; Isfahan University of Medical Sciences, Isfahan, Iran. 2Assistant Professor of Cardiology; Azad University of Najafabad, Isfahan, Iran. 3Researcher of Biochemistry; Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 4NajafAbad Azad University, Isfahan, Iran. 5Delasa Heart Center, Sina Hospital, Isfahan, Iran. 6Assistant Professor of Cardiac Surgery; Isfahan University of Medical Sciences, Isfahan, Iran. 7Shiraz University of Medical Science, Shiraz, Iran.8NajafAbad Azad University, Isfahan, Iran.

Citation: Mirmohammad-Sadeghi M, Etesampour A, Gharipour, M, Shariat Z, Nilforoush P, Saeidi M, Mackie M, Sadeghi FM. Early chest tube removal after coronary artery bypass graft surgery. North Am J Med Sci 2009; 1: 333-337.   
Doi: 10.4297/najms.2009.7333
Availability: www.najms.org
ISSN: 1947 – 2714

Abstract
Background: There is no clear data about the optimum time for chest tube removal after coronary artery bypass surgery. Aim: The aim of this study was to assess the impact of the chest tube removal time following coronary artery bypass grafting surgery on the clinical outcome of the patients. Material and Methods: An analysis of data from 307 patients was performed. The patients were randomized into two groups: in group 1 (N=107) chest tubes were removed within the first 24 hours after surgery, whereas in group 2 (N=200), chest tubes were removed in the second 24 hours after surgery. Demographics, lactate and pH at the beginning, during and after the operation, creatinine, left ventricular ejection fraction, inotropic drugs administration, length of ICU stay, and mortality data were collected. Respiratory rate and pain level was assessed. Results: In these surgeries, the mean± standard deviation for the aortic clamping time was 49.18±17.59 minutes and cardiopulmonary bypass time was 78.39±25.12 minutes. The amount of heparin consumed by the second group was higher (P <0.001) which could be considered as an important factor in increasing the drainage time after the surgery (P =0.047). The pain level evaluated 24 hours post-operation was lower in the first group, and the difference in the pain level between the 2 groups evaluated 30 hours post-operation was significant (P=0.016). The mean time of intensive care unit stay was longer in the second group but it was not statistically significant. Conclusion: Early extracting of chest tubes after coronary artery bypass graft surgery when there is no significant drainage can lead to pain reduction and consuming oxygen is an effective measure after surgery toward healing; it doesn't increase the risk of creation of plural effusion and pericardial effusion.

Keywords: Timing, chest tube removal, coronary artery bypass graft surgery
 
Correspondence to: Mojgan Gharipour Msc, Researcher of Biochemistry, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Tel.: 00989131030177. Email: gharipour@crc.mui.ac.ir