Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.06.010
Brazilian Journal of Anesthesiology
Clinical Research

Impact of drains positioning on pulmonary function after coronary artery bypass grafting: an observational study

Débora Santos de Oliveira Gomes; Elzane Jesus de Almeida Silva; Josimar Silva e Silva; Hayssa de Cássia Mascarenhas Barbosa; André Raimundo Guimarães; André Luiz Lisboa Cordeiro

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Abstract

Introduction
Coronary artery bypass grafting (CABG) is a procedure associated with a decline in pulmonary function. Among the main causes is the presence of the drain that is usually positioned in the intercostal or subxiphoid region.

Objective
To measure the interference of drains positioning on pulmonary function in patients undergoing CABG.

Methods
Observational study that assessed preoperative pulmonary function through vital capacity (VC), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF). These variables were evaluated in three different moments: in the presence of two drains, when removing one, and after removing all drains.

Results
We evaluated 45 patients with a mean age of 62 ± 7 years with male prevalence of 29 (64%) individuals. The insertion of drains caused a decline in pulmonary function after surgery by reducing MIP by 48%, MEP by 11%, VC by 39%, and PEF by 6%.

Conclusion
This study has demonstrated that drains positioning after CABG surgery may produce weakness of the respiratory muscles, change ventilatory mechanics, and impair normal pulmonary function postoperatively.

Keywords

Coronary artery bypass grafting;  Mechanical ventilation;  Postoperative pulmonary complications;  Pulmonary function;  Mediastinal drainage;  Pleural drainage
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Braz J Anesthesiol

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