Risk Factors for Prolonged Pleural Effusion after Total Cavopulmonary Connection by Multivariate Analysis / 日本心臓血管外科学会雑誌

ABSTRACT

We evaluated risk factors for prolonged pleural effusion after surgery in 35 children who underwent total cavopulmonary connection (TCPC). Duration of their chest tube drainage was 5.4±7.0 days (1-41, median 3). In univariate analysis, significant risk factors for prolonged pleural drainage over 7 days were preoperative body weight (<i>p</i>=0.03), preoperative cardiothoracic ratio (<i>p</i>=0.03), cardiopulmonary bypass (CPB) time (<i>p</i>=0.02), homologous blood transfusion (<i>p</i>=0.03), serum protein concentration at CPB weaning (<i>p</i>=0.04), central venous pressure (CVP) averaged during 3 postoperative days (<i>p</i>=0.01) and body weight change during 3 postoperative days (<i>p</i>=0.01). However multivariate analysis showed only CVP averaged during 3 postoperative days was a significant risk factor for prolonged chest tube drainage (<i>p</i>=0.03, odd's ratio 3.3). In conclusion, to keep the central venous pressure as low as possible during the early postoperative period might decrease the duration of pleural drainage.