New mediastinal drain after cardiac porcedures
Francisco T. Nobre1, Vera Lucia2, Marcelo Pochini2, José Menegolli1, Marcos CÉSAR2, Carlos Gonelli2, Mauro Machado3, Noedir Stolf2.
1Hospital Beneficencia Portuguesa São Paulo e São Caetano do Sul, São Paulo, Brazil, 2Hospital Beneficencia Portuguesa São Paulo, São Paulo, Brazil, 3Hospital Beneficencia Portuguesa São Paulo l, São Paulo, Brazil.
OBJECTIVE: The aim of the present study demonstrate the effectiveness of drain Mediastinal with balloon, with respect to permeability , blood drainage postoperatively and observation of cardiac tamponade.
From November 2011 to May 2012, drain mediatinal balloon was used in 101 patients (68 men, 33women, mean age 60.2 years). Underwent surgery for myocardial revascularization in 72 patients, the other patients the mitral valve replacement surgery in number of 17.12 patients to aortic valve replacement surgery.Patients with pleural drainage and bronchopleural fistula, were excluded.
All patients underwent extracorporeal circulation,the mediastinal drain with the balloon system was placed in the mediastinum prior to closure of the sternum, positioned at the longitudinal position, as usual in most cases above the pericardium. The patients at the conclusion of surgery were transferred to the intensive care unit for postoperative care, draining blood were calculated. The drains were removed only if there was less than 100 ml of blood. In the period up to 12 hours.
Total amount of blood drainage. Days spent with the drains, days in the ICU and hospital were documented.
Radiography was taken from routine. In the immediate postoperative period. In the second of post operative day and a day before the hospital discharge.
After the radiographs were Analyzed, If verified presence of increased mediastinal area or signs of tamponade, was prompted transthoracic echocardiogram
A Total of 101 patients ,undergoing balloon drainage system for a period of 06 months with the majority undergoing CABG surgery. The Drainage blood were documented at each time, observing if excessive bleeding happening .The protocol of balloon inflation were each hour, with
10 ml of air through an external syringe. On the
day of postoperative drains were removed, were observed in this analysis that all drains were patent, There were no cases of cardiac tamponade .
The mediastinal drain balloon demonstrated safe and effective for promoting blood drainage in postoperative period due facilitate the removal of clots. Thus offering a new tool and alternative to the mediastinal drainage in cardiac surgery.
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