When To Remove Drains After Coronary Bypass Surgery

Abstract

Background: Mediastinal and thoracic drains after open heart surgery are a vital preventive measure against postoperative cardiac tamponade. In this study, we investigated when to remove mediastinal and thoracal drains in patients who underwent isolated coronary bypass surgery. Material and Methods: A total of 446 patients who underwent elective isolated coronary artery bypass grafting (CABG) in our clinic between January 2015 and March 2017 were enrolled prospectively. Patients were divided into two groups: Group I (the last 24-hour drainage follow-up was under 150 ml) and Group II (last 24 hours drainage follow-up was under 50 ml). There were 210 patients (95 female, 115 male) in Group I and 236 patients (112 female, 124 male) in Group II. Postoperative Tamponade and pleural effusion rates, perioperative and postoperative blood usage rates, and preoperative demographic characteristics were recorded evaluated statistically. Results: The average age of the patients included in the study was 59,5 +/- 6,2, consisting of 239 male and 207 female patients. There were 210 patients (95 F, 115 M) in group I, 236 patients (112 F, 124 M) in group II. The mean amount of drainage; in Group I: 582 +/- 123 ml, in Group II: 614 +/- 205 ml. The average time of drain removal; Group I: 2.3 +/- 0.5 days, Group II: 4.1 +/- 0.3 days. Development rate of cardiac tamponade that required surgery on the first postoperative day; Group I: 5 (2.3%) and Group II: 3 (1.2%) respectively (p<0.05). Thoracentesis was required due to pleural effusion in 11 (5.2%) patients in group I and 6 (2.5%) patients in group II (p<0.05). The overall average age of the patients was 59.5 +/- 6.2 and consisted of 239 male and 207 female patients. Conclusion: It can be suggested that drains should not be removed until the drainage amount of the mediastinal and thoracal drains is reduced to 50 ml / day to further reduce the morbidity after isolated coronary bypass surgery.