The Thoracic and cardiovascular surgeon
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Pneumothorax can be a major complication following chest drain removal. As paediatric patients have poor breath-holding compliance, the incidence in this group may be raised compared to the adult population. A small pilot study in our hospital found a pneumothorax rate post chest drain removal of 6/39 (15.4%), which was high. The aim of this study was to determine the incidence of pneumothorax post paediatric chest drain removal after updating the guidelines for removal, and staff education. ⋯ This study found an incidence of pneumothorax post paediatric chest drain removal of 4.2%, an improvement since the initial pilot study. A good removal technique reduces complication rates with trained staff following structured guidelines less likely to encounter problems. The application of an occlusive dressing rapidly following suture failure helps to decrease exposure times and thus lowers the incidence of pneumothorax.
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Thorac Cardiovasc Surg · Aug 2011
Management of chylothorax with octreotide after congenital heart surgery.
Chylothorax is a rare complication of congenital cardiac surgery that can seriously impair the postoperative course unless treated properly. We present our treatment protocol and results with octreotide, a somatostatin analogue, in cases of chylothorax following congenital heart surgery. ⋯ Octreotide, a long-acting somatostatin analog, is an effective and safe agent for the treatment of postoperative chylothorax and warrants further investigation in a larger series with a greater number of patients.