Abida Jan, Mil Akhtar M Jamil, Kamran Hameed, Asghar Bhatti, Khalid Rehman Yousaf.
Prevalence & clinical outcome / course of pleural effusion in post CABG patients.
J Cardiovascular Dis Jan ;11(4):88-92.

BACKGROUND: Pleural effusion occurs commonly after CABG. Usually this effusion is small and asymptomatic. Large symptomatic effusion also occur but in a small proportion of patients. Pleural effusion after CABG can be associated with significant morbidity and prolonged hospital stay. Early diagnosis and management can reduce the morbidity and hospital stay of the patient. OBJECTIVE: Objectives of the study are to identify the risk factors and Severity of pleural effusion in post CABG patients. Material and Methods: The study was conducted in ICU cardiac surgery department of Punjab Institute of Cardiology Lahore between July 2011 to December 2011. 100 patients in cardiac surgery ICU of Punjab Institute of Cardiology Lahore were enrolled in study after fulfilling the inclusion criteria, Procedure of research was explained to the patient and informed consent was taken. Demographic data, name, age, gender, surgical procedure details, co-morbidities like COPD, EF, and smoking were recorded on the attached proforma. Patients were kept in cardiac surgery ICU for at least 7 days. They were assessed for presence and severity of pleural effusion on CXR. Daily CXR was done and examined by consultant chest physician on morning round. The size of effusion on the CXR was categorized as follow: small effusion occupied less than mid chest, large effusion occupied more than mid chest. Possible risk factors for developing the pleural effusion in post CABG patients were recorded. RESULTS: Out of total 100 post CABG patients with pleural effusion, majority (87%) of the patients were male. Mean age of the patient was 54.42±9.39. Left side pleurotomy was reported in majority (72%) patients. LIMA harvesting was reported in (88%) patients. Most of the patients (83%) suffered from left sided pleural effusion, (4%) from right sided, and (13%) had bilateral pleural effusion. Out of total 100 patients (79%) had small size (less than mid chest) of pleural effusion and (21%) had large size (more than mid chest) of symptomatic effusion. Out of 100 patients (27%) needed pleural aspiration. The level of serum albumin reduced in more than (90%) of patients. CONCLUSION: Majority of the patients after CABG developed left sided effusion of small size. Large size of pleural effusion also occurred but in a small proportion. The effusion mainly causes some respiratory symptoms that require pleural aspiration. LIMA harvesting, pleurotomy, and hypoalbuminemia were the major risk factors of pleural effusion in post CABG patients.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com