The effects of milking and suction drain management methods in paediatric patients after cardiac surgery
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Published on: December 16, 2015
Göksu Gökgöz1, Ükke Karabacak2, Zehra Kan Öntürk2
1Istanbul Training and Research Hospital, TR. Ministry of Health, İstanbul, Turkey.
Insights
Milking and suction methods effectively maintain drain patency in pediatric cardiac surgery patients, ensuring hemodynamic stability during the critical first six hours post-operation. These techniques are safe and do not significantly impact vital signs or bleeding volumes.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiac Care
- Surgical Drainage Management
Background:
- Maintaining drain patency is crucial for hemodynamic stability after pediatric cardiac surgery.
- Traditional methods may not always ensure optimal drainage, potentially affecting patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of milking and suction methods in maintaining chest drain patency.
- To assess the impact of these methods on hemodynamic stability in pediatric patients undergoing cardiac surgery.
Main Methods:
- A randomized controlled trial was conducted involving pediatric patients undergoing cardiac surgery.
- Patients were allocated to three groups: suction method, milking method, and a control group.
- Data on heart rate, blood pressure, oxygen saturation, body temperature, and bleeding volume were collected and analyzed.
Main Results:
- Neither suction nor milking methods significantly increased heart rate compared to the control group.
- Drain manipulation methods maintained blood pressure stability and did not adversely affect hemodynamic stability, oxygen saturation, or body temperature.
- While bleeding volumes showed no statistically significant difference, the suction method trended towards less bleeding than the milking method.
Conclusions:
- Milking and suction methods are viable options for maintaining drain patency and patient stability in the initial 6 hours after pediatric cardiac surgery.
- These techniques appear safe and do not compromise vital hemodynamic parameters.
- Further research is recommended to generalize these findings across diverse pediatric congenital heart disease populations.
Aim:
The aim of this study is to determine the effects of milking and suction methods on maintaining drain patency following cardiac surgery in paediatric patients.
Methods:
This was a randomized controlled trial. The patients were assigned to three groups (suction method, milking method, and control group) between July 2018 and December 2019.
Results:
The most frequent medical diagnoses were tetralogy of Fallot (34.4%, n = 31) and ventricular septal defect (14.4%, n = 13). Heart rate may increase unless a method was chosen to maintain drain patency (F: 4.450, p = 0.003); suction (F: 0.528 p = 0.781) and milking (F: 2.281 p = 0.070) methods did not significantly increase the heart rate. The use of a manipulation method for maintaining drain patency maintained stability of the blood pressure values and did not affect haemodynamic stability, oxygen saturation, and body temperature. There was no statistically significant difference within and among the groups (p > 0.05) in relation to the volume of bleeding between admission until the sixth hour, although there was greater bleeding with the milking method (2.67 ± 15.30 ml) and less bleeding (-5.00 ± 23.30) with the suction method.
Conclusion:
The milking and suction methods used to maintain drain patency can be employed and will assist with maintaining the stability of the patient within the first critical 6 h. Further studies need to be conducted in order to clarify that the recommendations can be generalized to all children with congenital heart disease.
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