A Single Institution Evaluation of the Performance of Two Different Chest Drainage Systems in Pediatric Patients after Surgery for Congenital Heart Disease

Abstract

Background The study compares the efficacy and advantages of two different drainage systems in pediatric patients during surgery for congenital heart disease (CHD).

Methods A total of 200 consecutive pediatric patients (< 16 years) were enrolled; in 100 patients we used a polyvinyl chloride drain (PVCD) and in the other 100 we used a silicone drain (SD). Demographics, drain's technical data, and postoperative complications and costs were evaluated. A pain score was calculated in patients older than 6 years.

Results The SDs were significantly smaller when compared with PVCDs (median of 1.63 vs. 3.09 French/kg, p = 0.0006), were kept in site for a median shorter period (23 vs. 40 hours, p = 0.002), drained more thoracic spaces (median of 2 vs. 1, p < 0.0001), and were associated to a lower pain score (p = 0.01). The overall drain-related complication rate was lower for the SD group than for the PVCD group (3 vs. 9%, p = 0.1) as well as the drain-related adverse event required additional interventional maneuvers (0 vs. 6%, p = 0.04). Patients who were treated with a PVCD reported a higher perceived pain score than patients treated with a SD, both at the time when the drain was in site (p = 0.016) and during the drain's removal (p = 0.0001).

Conclusion SDs can be used safely in pediatric patients during surgery for CHD. Sizes required are smaller than other conventional drains and multiple cavities can be drained with a single tube. The use of SD is associated to a lower complication rate, lower requirement of additional procedures, and lesser perceived pain from the patient, when compared with other more traditional drains.

Keywords

congenital heart disease - cardiac surgery - chest drainage

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