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The normative distribution of chest tube drainage volume after coronary artery bypass grafting
Rochelle Wynne1, Mari Botti, Deana Copley
1School of Nursing, Faculty of Health and Behavioural Sciences, Deakin University, Burwood, Australia.
Insights
Chest tube (CT) drainage after coronary artery bypass grafting (CABG) typically plateaus 8 hours post-surgery. This study maps CT drainage patterns, suggesting further research into removal timing and influencing factors.
Area of Science:
- Cardiovascular Surgery
- Thoracic Drainage Management
- Postoperative Care
Background:
- Limited data exists on expected chest tube (CT) drainage volumes following coronary artery bypass grafting (CABG).
- Understanding drainage patterns is crucial for optimizing patient recovery and managing potential complications.
Purpose of the Study:
- To characterize the temporal changes in chest tube (CT) drainage volumes from insertion to removal after coronary artery bypass grafting (CABG).
- To establish a baseline understanding of CT drainage trajectories in patients undergoing CABG.
Main Methods:
- Retrospective, descriptive study design.
- Inclusion of 239 patients who underwent CABG at a single metropolitan hospital.
- Analysis of chest tube drainage volumes and duration of insertion.
Main Results:
- The study included 234 patients (predominantly male, 79.1%) with a mean age of 68.7 years.
- Mean chest tube insertion duration was 45.2 hours, with a total mean drainage volume of 1300.6 mL.
- Drainage volumes plateaued to approximately 31 mL/hour at 8 hours post-surgery, decreasing to 21 mL/hour between 24-48 hours. Significant gender variations in drainage were observed.
Conclusions:
- Chest tube drainage patterns after CABG show a plateau approximately 8 hours post-surgery.
- Further research is recommended to compare standard versus earlier chest tube removal times.
- Prospective studies across multiple centers are needed to identify factors influencing drainage variations.
Background:
Little evidence exists to describe expected volumes of chest tube (CT) drainage after coronary artery bypass grafting (CABG).
Objectives:
The study objective was to map the trajectory of CT drainage volumes from insertion to removal after CABG.
Design:
This was a retrospective, descriptive study.
Patients:
The study included 239 patients who underwent CABG at a single metropolitan hospital in Melbourne, Australia.
Results:
The sample (N = 234), aged 68.7 years (standard deviation [SD] 9.9), was predominantly male (N = 185, 79.1%). The mean duration of CT insertion was 45.2 hours (SD 26.7), and total drainage volume was 1300.6 mL (SD 763.8). Drainage volumes plateau to 31 mL per hour, 8 hours after surgery. From 24 to 48 hours, the mean drainage was 21 mL per hour. Drainage volumes varied between genders.
Conclusions:
Evidence of similar drainage patterns in other populations is difficult to locate. If the pattern of drainage shown in this study is consistent, experimental intervention studies comparing standard removal time and earlier removal are recommended. If not, prospective collection of relevant preoperative, intraoperative, and postoperative factors across multiple sites is necessary to determine which patient or practice variations influence CT drainage patterns after CABG.
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