Do we need more than one mediastinal drain in cardiac surgery?

Authors

  • Dhananjay Bansal Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
  • Soumya Guha Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
  • Ashish Sharma Department of Cardiothoracic and Vascular Surgery, Venkateshwar Hospital, New Delhi, India
  • Anubhav Gupta Department of Cardiothoracic and Vascular Surgery, Vardhaman Mahavir Medical College, Safdarjung Hospital, New Delhi, India
  • Narender Singh Jhajhria Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
  • Palash Aiyer Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
  • Vijay Grover Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India
  • Vijay Kumar Gupta Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20192383

Keywords:

Cardiac surgery, Mediastinal drain, Post-operative

Abstract

Background: Placement of mediastinal drains after cardiac surgery is standard of care. However, there is no consensus over the number of drains to be placed. Is there any advantage of multiple drains over a single drain? This question formed the premise of this study.

Methods: All consecutive patients operated between 2014 and 2015 were included. Those with pleural drains were excluded. Patients had either a single drain in the pericardial cavity or had two drains, one in the pericardial and the other in retrostenal area. A total of 244 patients were included in the study group.

Results: Out of 244 patients, 122 had single drain and 122 had 2 mediastinal drains. The mean age was 24.38±17.08 (Age range 6 months to 66 years) and male: female ratio was 1.5:1. There was no statistically significant difference in single drain vs double drain group in terms of the number of days of drainage (1.65 vs 1.55, p 0.325), time to mobilize (36.57 vs 35.23 hours, p=0.684), ICU stay (2.62 vs 2.63 days, p=0.96)and re-exploration (5.7%, vs 9.8%, p=0.34). However, patients with two mediastinal drains had higher requirement of analgesia (p=0.004).

Conclusions: The use of two mediastinal drains does not confer any advantage over a single mediastinal drain after cardiac surgery in assessing or controlling bleed or recovery. However, the post-operative pain is significantly higher with use of two mediastinal drains.

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Author Biographies

Dhananjay Bansal, Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

Cardiothoracic vascular surgery ( CTVS ), senior resident

Soumya Guha, Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

CTVS, SR

Ashish Sharma, Department of Cardiothoracic and Vascular Surgery, Venkateshwar Hospital, New Delhi, India

CTVS

Anubhav Gupta, Department of Cardiothoracic and Vascular Surgery, Vardhaman Mahavir Medical College, Safdarjung Hospital, New Delhi, India

CTVS, Professor

Narender Singh Jhajhria, Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

CTVS, professor

Palash Aiyer, Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

CTVS

Vijay Grover, Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

CTVS, Professor

Vijay Kumar Gupta, Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Dr. RML Hospital, New Delhi, India

CTVS, Professor, Head of The Department

References

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Published

2019-05-28

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Section

Original Research Articles