The importance of intrapericardial drain selection in cardiac surgery.
BACKGROUND
To explore the impact of intrapericardial and infracardiac drains on pericardial effusions in cardiac surgery.


METHODS
Patients undergoing coronary artery bypass grafting were randomized into two groups. At the end of the intervention, an intrapericardial and infracardiac Blake drain was placed in patients in group 1 (n = 97), and an intrapericardial and infracardiac semirigid drain was placed in patients in group 2 (n = 105). In addition, a semirigid drain was placed into mediastinum in all cases. The amount of drainage was calculated at six different time points postoperatively: postoperative 0 to 2 h, postoperative 2 to 4 h, postoperative 4 to 6 h, postoperative 6 to 12 h, postoperative 12 to 24 h, and postoperative 24 to 48 h. The amount of pericardial effusion was estimated by transthoracic echocardiography after the drains were removed.


RESULTS
In all measurements, the amount of drainage from intrapericardial Blake drains was higher, the total amount of drainage being equal to 330.7 +/- 29.4 mL and 193.2 +/- 19.6 mL in the Blake drain and semirigid drain groups, respectively (p = 0.000) [mean +/- SD]. When the drains were removed, the volume of pericardial effusion was 3.86 +/- 0.76 mm in Blake drain group and 7.59 +/- 1.16 mm in semirigid drain group (p = 0.000). The incidence of postoperative atrial fibrillation was 11.3% in the group with Blake drains, and 23.8% in the group with semirigid drains (p = 0.016).


CONCLUSIONS
The more effective drainage obtained with infracardiac Blake drains compared to semirigid drains helps to reduce the amount of postoperative pericardial effusion and the risk of atrial fibrillation.
Ege
Turan
T
Trakya University Medicine Faculty, Department of Cardiovascular Surgery, 22030 Edirne, Turkey. turanege@ttnet.net.tr
Tatli
Ersan
E
Canbaz
Suat
S
Cikirikcioglu
Mustafa
M
Sunar
Hasan
H
Ozalp
Bilhan
B
Duran
Enver
E
D001026:Coronary Artery Bypass / Q000379:methods* / Q000592:standards; D004322:Drainage / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*