COMPARISON BETWEEN EARLY AND LATE CHEST DRAINS REMOVAL POST CORONARY ARTERY BYPASS GRAFTING, REGARDING POST OPERATIVE CLINICAL OUTCOME; IS THERE ANY DIFFERENCE?

Abstract

Objective: The goal of this study is to highlight the consequences of various timing of chest tube removal
following coronary artery by pass grafting on patients postoperative course.
Material and methods: This is prospective randomized study which was conducted in Queen Alia heart
institute between January 2010 to June 2010 on 202 patients who underwent coronary artery by pass grafting.
Patients were divided into two groups each consisted of 101 patients, group A where patients that had their chest
drains removed after 24hrs, where group B had their chest drains removed after 48hrs.
Results: In group A, 65.2% were males where in group B 64.8% were males, mean age was 58.59±8.3year,
59.48±7.3year for group A, B respectively. Regarding operative details TPT (total pump time) was 77.42± 23.32
minute for group A, while it was 79.52±22.0 minute for group B.
In group A 9.75% of patients developed significant left pleural effusion, while 7.8% developed significant left
pleural effusion in group B, P > 0.5. At the same time, 52.9% of patients in group A developed pericardial
effusion while 47% developed pericardial effusion in group B, P>0.10.
Concerning mobilization, 21.5% patients in group A are mobilized after 24 hrs in contrast to 10.7% in group B,
P < 0.05. Evidence of atelectasis on CXR or chest CT scan was found in 42.15% in group A in contrast to 57.8%
in group B, P < 0.05.
Conclusion: Timing of chest drain in patient who underwent coronary artery bypass grafting whether early or
late was not found to be related to the post operative development of pleural effusion or pericardial effusion,
however, early chest drains removal helps in early mobilization of patients due to less post operative pain, at the
same time, this resulted also, in less incidence of atelectasis and chest infection.
Key words: Chest drain, coronary artery bypass graft, timing, removal.