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Left lateral intercostal region versus subxiphoid position for pleural drain during elective coronary artery bypass graft surgery: randomized clinical trial
Simon, Sandra; Coronel, Christian; Almeida, Adriana Silveira de; Marcadenti, Aline.
  • Simon, Sandra; Hospital Nossa Senhora da Conceição Hospital. Cardiology and Cardiac Surgery Services. Porto Alegre. BR
  • Coronel, Christian; La Salle University. Canoas. BR
  • Almeida, Adriana Silveira de; Hospital Nossa Senhora da Conceição Hospital. Cardiology and Cardiac Surgery Services. Porto Alegre. BR
  • Marcadenti, Aline; Hospital do Coração. Instituto de Pesquisa. São Paulo. BR
São Paulo med. j ; 137(1): 66-74, Jan.-Feb. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1004734
ABSTRACT
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.
Asunto(s)


Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Drenaje / Puente de Arteria Coronaria / Cavidad Pleural Tipo de estudio: Ensayo Clínico Controlado / Estudio de etiología / Estudio pronóstico Límite: Adulto / Anciano / Aged80 / Femenino / Humanos / Masculino Idioma: Inglés Revista: São Paulo med. j Asunto de la revista: Cirurgia Geral / Ciˆncia / Ginecologia / Medicina / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Año: 2019 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Hospital Nossa Senhora da Conceição Hospital/BR / Hospital do Coração/BR / La Salle University/BR

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Drenaje / Puente de Arteria Coronaria / Cavidad Pleural Tipo de estudio: Ensayo Clínico Controlado / Estudio de etiología / Estudio pronóstico Límite: Adulto / Anciano / Aged80 / Femenino / Humanos / Masculino Idioma: Inglés Revista: São Paulo med. j Asunto de la revista: Cirurgia Geral / Ciˆncia / Ginecologia / Medicina / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Año: 2019 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Hospital Nossa Senhora da Conceição Hospital/BR / Hospital do Coração/BR / La Salle University/BR