title: [Withdrawal of chest tubes without water seal vs. negative continuous suction after closed cardiovascular surgery procedures in children].
abstract: BACKGROUND
  We undertook this study to compare the frequency and type of complications, as well as the length of hospital stay, in children who underwent closed cardiovascular surgery with chest tube drainage during the postsurgical period with children in whom the drainage was withdrawn with continuous suction, once thoracotomy was completed.
  
  
  METHODS
  A retrospective, descriptive and analytic study was performed at the IMSS Hospital de Pediatria, located at the XXI Century National Medical Center in Mexico City. Eighty eight children who underwent closed cardiovascular surgery (Group I) without chest tubes and 42 with chest tubes (Group II) were studied.
  
  
  RESULTS
  In Group I the frequency of complications was 27.3% and in group II 59.5%. Complications were as follows: subcutaneous emphysema was seen in 13.6% (n=12) of group I and in 45.2% (n=19) of group II (p=0.0001); pneumothorax in 13.6% (n=12) vs. 28.6% (n=12), p=0.04; and chylothorax in 2.3% (n=2) vs. 2.4% (n=1), p=1.0, respectively. The median time of hospital stay in group I was 3 days and in group II was 6 days (p=0.0001).
  
  
  CONCLUSIONS
  In children, in some closed cardiovascular surgeries, withdrawal of chest tube drainage with negative suction when thoracotomy is completed may decrease the frequency of pneumothorax, subcutaneous emphysema and length of hospital stay, in comparison with patients in whom chest tube drainage is left during the postoperative period.
authors.affiliation: Unidad de Cuidados Intensivos Neonatales, Hospital de Pediatría, cuarto piso, Centro Médico Nacional Siglo XXI, IMSS, Av. Cuauhtémoc 330, Col. Doctores, 06720 México, D.F., México. hely1802@yahoo.com.mx
authors.forename: Heladia Josefa
authors.initials: HJ
authors.lastname: García
authors.forename: Ricardo
authors.initials: R
authors.lastname: Villalpando-Canchola
authors.forename: Luis
authors.initials: L
authors.lastname: Ramírez-Meléndez
authors.forename: Octavio
authors.initials: O
authors.lastname: Herrera-Verdugo
authors.forename: Joaquín Rodolfo
authors.initials: JR
authors.lastname: Zepeda-Sanabria
authors.forename: Mario
authors.initials: M
authors.lastname: Franco-Gutiérrez
authors.forename: Carlos David
authors.initials: CD
authors.lastname: González-Lara
mesh_terms: D002318:Cardiovascular Diseases / Q000601:surgery*; D015505:Chest Tubes; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013396:Suction / Q000379:methods