Unnecessity of routine chest tube drainage after patent ductus arteriosus ligation in preterm neonates.
Drainage
Intensive care unit
Neonate
Patent ductus arteriosus
Preterm birth
Thoracotomy
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
20 Oct 2023
20 Oct 2023
Historique:
received:
24
03
2023
accepted:
08
10
2023
medline:
23
10
2023
pubmed:
20
10
2023
entrez:
20
10
2023
Statut:
epublish
Résumé
Conventionally, 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. We 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. The 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. Omitting chest tube drainage is feasible and safe for the postoperative management of preterm neonates undergoing PDA ligation via thoracotomy.
Sections du résumé
BACKGROUND
BACKGROUND
Conventionally, 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.
METHODS
METHODS
We 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.
RESULTS
RESULTS
The 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.
CONCLUSIONS
CONCLUSIONS
Omitting chest tube drainage is feasible and safe for the postoperative management of preterm neonates undergoing PDA ligation via thoracotomy.
Identifiants
pubmed: 37858197
doi: 10.1186/s13052-023-01548-y
pii: 10.1186/s13052-023-01548-y
pmc: PMC10588261
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
142Subventions
Organisme : Kyungpook National University Hospital
ID : 2018-신진-27
Informations de copyright
© 2023. Società Italiana di Pediatria.
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