Changes of thoracic drainage volume and their relationship with prognosis after lung transplantation

Abstract

Objective To observe the changes of thoracic drainage volume after lung transplantation, and to explore the influencing factors and their relationship with the prognosis of lung transplantation. Methods This retrospective analysis included 46 consecutive lung transplantations in our hospital between 2005 and 2016.The volume of postoperative chest drainage was recorded and analyzed.Single factor analysis of the factors that may affect the drainage was done.The patients were divided into different groups according to different prognosis at different time points after operation, and drainage volume was compared among groups.All analyses were performed with SPPS, version 19.0. Results There were no operative deaths.The median thoracic drainage time was 9.3 days, the median total thoracic drainage volume was 4318 mL, and the average daily drainage volume was 487 mL.During the perioperative period, the use of cardiopulmonary bypass or extracorporeal membrane oxygenation increased significantly the volume of unilateral pleural drainage (P<0.05). The average daily drainage volume and the average daily unilateral pleural drainage volume in the postoperative dead patients were significantly greater than those of survivals at 1st month, 3rd month and 1st year after lung transplantation (P<0.05). At 3rd month after transplantation, the total amount of postoperative thoracic drainage was significantly greater than that of survivals (P<0.05). The average daily unilateral pleural drainage volume in dead patients after surgery was significantly greater than that of the survival patients 3 years after operation (P<0.05). Conclusion Intraoperative hemostasis in patients with lung transplantation should receive considerable attention, cardiopulmonary bypass and extracorporeal membrane oxygenation should be used cautiously during perioperative period, and greater postoperative chest drainage predicated poor short-term prognosis. Key words: Lung transplantation; Chest drainage; Prognosis