Methods of pericardial, anterior mediastinal, and pleural drainage in children after cardiac surgery

The aim of the study was to develop a method of drainage tube placement for efficient fluid drainage from anterior mediastinum, pericardial and pleural cavities in children after cardiac surgery with or without bypass. From January 2008 to December 2010, a total of 158 children underwent cardiac surgery at the Institute for Cardiology of the Siberian Branch under the Russian Academy of Medical Sciences. Patients were divided into two groups. The first group consisted of 83 children with an average age of 4±2 months (from 10 days to 5 years of age) and an average weight of 4.9±2.5 kg (from 2 to 18 kg). In this group, the drainage tubes were inserted by the newly developed method. The second group included patients (n=75) with an average age of 5±2.3 months (from 18 days to 6 years of age) and an average weight of 5.6±2.4 kg (from 2.5 to 20 kg). In this group, the drainage tubes were placed by a standard method (4 drain tubes in patients with open pleural cavity and 2 drain tubes in cases when pleural space remained intact). The groups did not significantly differ by age, weight, disease severity, duration of major surgery stages, and postoperative blood loss. The developed method allowed to decrease the number of the drainage tubes in patients with both open pleural cavity (2 vs. 4 tubes) and intact pleural cavity (1 vs. 2 tubes). There were no serious, life threatening, complications in the early postoperative period. No patients in either group developed complications during the drainage tube removal; no inadequate fluid drainage events were documented. The study showed that the developed method of drainage tube insertion was efficient and reduced the number of the tubes twice without increasing the risk of early postoperative complications.