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Parameters affecting pleural drainage and a management strategy after Fontan operation
  • +5
  • Servet Ergün,
  • okan yildiz,
  • Pelin Ayyildiz,
  • Erman Çilsal,
  • Erkut Öztürk,
  • Ismihan Onan,
  • Alper Güzeltas,
  • Sertac Haydin
Servet Ergün
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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okan yildiz
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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Pelin Ayyildiz
İstanbul Mehmet Akif Ersoy, Thoracic and Cardiovascular Surgery Center and Research Hospital
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Erman Çilsal
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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Erkut Öztürk
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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Ismihan Onan
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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Alper Güzeltas
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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Sertac Haydin
Mehmet Akif Ersoy Thoracic and Cardiovascular Research and Education Hospital
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Abstract

Background: Prolonged pleural drainage after the Fontan procedure is a common complication. Various protocols have been described, but there is no definitive consensus for the treatment of this complication. Materials and Methods: Our primary aim was to determine the effect of the protocol on the duration of drainage and hospital stay. Our secondary aim was to determine parameters affecting prolonged drainage after the Fontan procedure. Ninety two consecutive patients who underwent the Fontan operation retrospectively analyzed. A protocol-based postoperative management was adopted at July 2018. Patients operated before the protocol were defined as Group 1(n=48), and patients operated after the protocol were defined as Group 2(n=44). Results: The mean age was 5(IQR 4.0-6.9) years the mean body weight was 17.3 (IQR 15.1-21.8) kg.There were statistically significant differences between groups in terms of total drainage, duration of pleural drainage, prolonged drainage and, LOHS(p=0.05,p=0.04, p=0.04,p=0.04,respectively). In the multivariate analysis, the application of the protocol was observed to be the only factor for prolonged drainage (OR:2.46, 95% CI Lower-Upper:1.03-5.86,p=0.04). Conclusion: Standardization and strict application of the medical treatment within a specific protocol without being affected by doctor, nurse or patient-based factors increases the success. After the changes in our medical management strategy, along with the decrease in total drainage and duration of pleural drainage, LOHS was also reduced, of course together with a reduction in the cost. Key Words: Fontan, pleural drainage, hospital stay, protocol

Peer review status:ACCEPTED

08 May 2020Submitted to Journal of Cardiac Surgery
09 May 2020Submission Checks Completed
09 May 2020Assigned to Editor
09 May 2020Reviewer(s) Assigned
12 May 2020Review(s) Completed, Editorial Evaluation Pending
12 May 2020Editorial Decision: Revise Major
13 May 20201st Revision Received
14 May 2020Assigned to Editor
14 May 2020Submission Checks Completed
14 May 2020Reviewer(s) Assigned
14 May 2020Review(s) Completed, Editorial Evaluation Pending
15 May 2020Editorial Decision: Revise Minor
16 May 20202nd Revision Received
16 May 2020Submission Checks Completed
16 May 2020Assigned to Editor
17 May 2020Reviewer(s) Assigned
19 May 2020Review(s) Completed, Editorial Evaluation Pending
19 May 2020Editorial Decision: Accept