Unnecessity of routine chest tube drainage after patent ductus arteriosus ligation in preterm neonates

Italian Journal of Pediatrics

Research

Youngok Lee¹  Hanna Jung¹ 

[1] Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, 41944, Daegu, Republic of Korea;

关键词: Drainage;    Intensive care unit;    Neonate;    Patent ductus arteriosus;    Preterm birth;    Thoracotomy;   

DOI  :  10.1186/s13052-023-01548-y

 received in 2023-03-24, accepted in 2023-10-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundConventionally, a chest tube drainage is placed following patent ductus arteriosus (PDA) ligation to monitor possible bleeding and drain air or effusion postoperatively. However, the necessity of chest tube drainage after thoracotomy in PDA ligation is controversial. We evaluated the feasibility and safety of omitting chest tube drainage in preterm neonates who underwent PDA ligation via thoracotomy.MethodsWe retrospectively reviewed the medical records of 56 preterm neonates who underwent surgical ligation of PDA via thoracotomy in the neonatal intensive care unit between January 2014 and March 2022.ResultsThe median gestational age was 26.9 (interquartile range [IQR]: 25.9–28.8) weeks and the median body weight at birth was 895 (IQR: 795–1190) g. The median age on the day of surgery was 17.0 (IQR: 10.0–22.0) days and the median body weight on the day of surgery was 1100 (IQR: 958–1410) g. The median operative time was 44.5 (IQR: 35.5–54.0) minutes. There were no intraoperative events or procedure-related deaths. On postoperative chest radiographs, no patients had major complications, such as pneumothorax or hemothorax. Nineteen patients (34%) had minor complications of subcutaneous emphysema around the thoracotomy site. No patients required additional chest tube drainage for postoperative bleeding, pleural effusion, or progressive subcutaneous emphysema. No patients had surgical wound infections. There were seven in-hospital mortalities, which were unrelated to the surgery.ConclusionsOmitting chest tube drainage is feasible and safe for the postoperative management of preterm neonates undergoing PDA ligation via thoracotomy.

【 授权许可】

CC BY   
© Società Italiana di Pediatria 2023

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