INTRODUCTION
The importance of chest tube insertion after open-heart surgery is not
covered. Chest tube insertion is routine after heart surgery, according
to statistics published by the International Classification of Diseases,
chest tube placement is performed annually for 133,000 US hospitalized
patients, that is contemplative1,2 and yet there is no
guideline for management of chest tube removal.3Proper management of chest tube improves factors such as reduced
pericardial and pleural effusion rates, decreases patient pain, chest
tube replacement, and length of hospital stay, and on the other hand, it
improves respiratory status and many more.3-5 Given
the fact that timely management of chest tube removal has many benefits
and there are indeed prediction models for heart
surgery6,7 but there is controversy over the right
time for nurses and surgeons because these models are not specific and
practical.8-10 For example, some surgeons find it
helpful from the empirical evidence to remove the chest tube early, and
others believe that delaying it has more benefits.11This is strongly influenced by the fact that perhaps there is a lack of
credible evidence and research about this issue.12-14However, we know that pleural effusion is likely after the chest tube
removal, but there is no consensus on the choice of the appropriate
diagnostic test to identify pleural effusion.15,16This is another reason that makes it difficult to decide the right time
to chest tube removal. It has even been suggested that taking X-ray
after chest tube removal does not help the patient’s management and is
recommended in the presence of clinical symptoms.17-19
Given the above, it is difficult to make decisions about the timing of
chest tube removal, so the present systematic review aimed to compare
the effect of early and late chest tube removal on pleural effusion in
patients undergoing coronary artery bypass graft surgery.