Left Lateral Intercostal Region Versus Subxiphoid Position for Pleural Drain During Elective Coronary Artery Bypass Graft Surgery: Randomized Clinical Trial

Overview

Journal Sao Paulo Med J

Specialty General Medicine

Date 2019 May 23

PMID 31116274

Citations 2

Authors

Sandra Simon

Christian Coronel

Adriana Silveira de Almeida

Aline Marcadenti

Affiliations

Soon will be listed here.

Abstract

Background: The pleural drain insertion site after coronary artery bypass graft (CABG) surgery may alter lung function, especially respiratory muscle strength. The main objective of this study was to compare the effectiveness and safety of use of the left lateral intercostal region versus the subxiphoid position for pleural drainage during elective CABG surgery using extracorporeal circulation (ECC).

Design And Setting: Randomized trial conducted in a tertiary-level hospital in Porto Alegre, Brazil.

Methods: 48 patients were assigned to group 1 (pleural drain in the left lateral intercostal region) or group 2 (pleural drain in the subxiphoid position). Respiratory muscle strength was measured in terms of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), in cmH2O, by means of manovacuometry preoperatively, 24 and 72 hours after drain removal and before discharge from hospital. Painand dyspnea scales, presence of infections, pleural effusion and atelectasis, duration of drain use, drainage volumes and surgical reinterventions were also evaluated.

Results: After adjustments, there were no significant differences between the groups at the end of the study (before discharge), in predicted percentages either for MIP (delta group 1: -17.21% versus delta group 2: -22.26%; P = 0.09) or for MEP (delta group 1: -9.38% versus delta group 2: -13.13%; P = 0.17). Therewere no differences between the groups in relation to other outcomes.

Conclusion: There was no difference in maximal respiratory pressures in relation to the pleural drain insertion site among patients who underwent CABG surgery using ECC.

Trial Registration: ReBEc V1111.1159.4447.

Citing Articles

Comparison of Intercostal and Subxiphoid Left Pleural Drain After Coronary Artery Bypass Grafting (CABG) Surgery: A Systematic Review and Meta-Analysis.

Mehsare P, Borkar N, Kashyap N, Saurabh G, Chakraborty N Cureus. 2024; 16(6):e61710.

PMID: 38975421 PMC: 11226205. DOI: 10.7759/cureus.61710.

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis.

Marza-Florensa A, Drotos E, Gulayin P, Grobbee D, Irazola V, Klipstein-Grobusch K Glob Heart. 2022; 17(1):37.

PMID: 35837361 PMC: 9187244. DOI: 10.5334/gh.1124.

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