Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial

OBJECTIVES:. To evaluate the safety and efficacy of an early chest tube removal protocol in reducing tube duration without increasing complications following pediatric cardiac surgery. DESIGN:. A single-center, randomized controlled trial. SETTING:. Pediatric cardiac ICU. PATIENTS:. Two hundred fift...

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Main Authors: Abdulraouf M.Z. Jijeh, MD, Ghassan A. Shaath, MD, Sameh R. Ismail, MD, Mohamed S. Kabbani, PhD, Omar M. Hijazi, MD, Hayan Altaweel, MD, Husam Hamada, MD, Ammar Qadi, MD, Anis Fatima, MD, Abdrabo Abdrabo, MD, Wiaam Ahmed, MD, Nuha Ahmed, MD, Ahmed Elsaoudi, MD, Ahmed Yousef, MD, Rehana Shafi, MD, Husam I. Ardah, PhD, Ahmad Elwy, MD, Abdullah A. Alghamdi, MD
Format: Article
Language:English
Published: Wolters Kluwer 2025-06-01
Series:Critical Care Explorations
Online Access:http://journals.lww.com/10.1097/CCE.0000000000001271
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author Abdulraouf M.Z. Jijeh, MD
Ghassan A. Shaath, MD
Sameh R. Ismail, MD
Mohamed S. Kabbani, PhD
Omar M. Hijazi, MD
Hayan Altaweel, MD
Husam Hamada, MD
Ammar Qadi, MD
Anis Fatima, MD
Abdrabo Abdrabo, MD
Wiaam Ahmed, MD
Nuha Ahmed, MD
Ahmed Elsaoudi, MD
Ahmed Yousef, MD
Rehana Shafi, MD
Husam I. Ardah, PhD
Ahmad Elwy, MD
Abdullah A. Alghamdi, MD
author_facet Abdulraouf M.Z. Jijeh, MD
Ghassan A. Shaath, MD
Sameh R. Ismail, MD
Mohamed S. Kabbani, PhD
Omar M. Hijazi, MD
Hayan Altaweel, MD
Husam Hamada, MD
Ammar Qadi, MD
Anis Fatima, MD
Abdrabo Abdrabo, MD
Wiaam Ahmed, MD
Nuha Ahmed, MD
Ahmed Elsaoudi, MD
Ahmed Yousef, MD
Rehana Shafi, MD
Husam I. Ardah, PhD
Ahmad Elwy, MD
Abdullah A. Alghamdi, MD
author_sort Abdulraouf M.Z. Jijeh, MD
collection DOAJ
description OBJECTIVES:. To evaluate the safety and efficacy of an early chest tube removal protocol in reducing tube duration without increasing complications following pediatric cardiac surgery. DESIGN:. A single-center, randomized controlled trial. SETTING:. Pediatric cardiac ICU. PATIENTS:. Two hundred fifteen pediatric patients with chest tubes after cardiac surgery. INTERVENTIONS:. Patients were randomized to early removal (drainage threshold < 6 mL/kg over 8 hr) or late removal (24-hr assessment) groups. Primary outcomes included chest tube duration, whereas secondary outcomes encompassed ICU stay, ventilation time, hospital stay, and complication rates. MEASUREMENTS AND MAIN RESULTS:. Median chest tube duration was significantly shorter in the early removal group (3 d) compared with the late removal group (4.9 d; p < 0.0001). Rates of fluid reaccumulation and pneumothorax were low and comparable between groups. Notably, no patients in either group required tube reinsertion. ICU and total hospital stay durations were similar across groups. CONCLUSIONS:. An early chest tube removal protocol following pediatric cardiac surgery suggests a reduction in chest tube duration without increasing the risk of complications. These findings support the adoption of an evidence-based early removal approach to enhance patient comfort and optimize ICU resource utilization in pediatric cardiac surgery patients.
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spelling doaj-art-e99e34087e6341eda0af0d1324839faa2025-08-20T02:10:29ZengWolters KluwerCritical Care Explorations2639-80282025-06-0176e127110.1097/CCE.0000000000001271202506000-00007Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled TrialAbdulraouf M.Z. Jijeh, MD0Ghassan A. Shaath, MD1Sameh R. Ismail, MD2Mohamed S. Kabbani, PhD3Omar M. Hijazi, MD4Hayan Altaweel, MD5Husam Hamada, MD6Ammar Qadi, MD7Anis Fatima, MD8Abdrabo Abdrabo, MD9Wiaam Ahmed, MD10Nuha Ahmed, MD11Ahmed Elsaoudi, MD12Ahmed Yousef, MD13Rehana Shafi, MD14Husam I. Ardah, PhD15Ahmad Elwy, MD16Abdullah A. Alghamdi, MD171 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.1 Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.3 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.5 Department of Cardiac Sciences, Division of Cardiac Surgery, Ministry of National Guard—Health Affairs, Riyadh, Saudi Arabia.2 King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.OBJECTIVES:. To evaluate the safety and efficacy of an early chest tube removal protocol in reducing tube duration without increasing complications following pediatric cardiac surgery. DESIGN:. A single-center, randomized controlled trial. SETTING:. Pediatric cardiac ICU. PATIENTS:. Two hundred fifteen pediatric patients with chest tubes after cardiac surgery. INTERVENTIONS:. Patients were randomized to early removal (drainage threshold < 6 mL/kg over 8 hr) or late removal (24-hr assessment) groups. Primary outcomes included chest tube duration, whereas secondary outcomes encompassed ICU stay, ventilation time, hospital stay, and complication rates. MEASUREMENTS AND MAIN RESULTS:. Median chest tube duration was significantly shorter in the early removal group (3 d) compared with the late removal group (4.9 d; p < 0.0001). Rates of fluid reaccumulation and pneumothorax were low and comparable between groups. Notably, no patients in either group required tube reinsertion. ICU and total hospital stay durations were similar across groups. CONCLUSIONS:. An early chest tube removal protocol following pediatric cardiac surgery suggests a reduction in chest tube duration without increasing the risk of complications. These findings support the adoption of an evidence-based early removal approach to enhance patient comfort and optimize ICU resource utilization in pediatric cardiac surgery patients.http://journals.lww.com/10.1097/CCE.0000000000001271
spellingShingle Abdulraouf M.Z. Jijeh, MD
Ghassan A. Shaath, MD
Sameh R. Ismail, MD
Mohamed S. Kabbani, PhD
Omar M. Hijazi, MD
Hayan Altaweel, MD
Husam Hamada, MD
Ammar Qadi, MD
Anis Fatima, MD
Abdrabo Abdrabo, MD
Wiaam Ahmed, MD
Nuha Ahmed, MD
Ahmed Elsaoudi, MD
Ahmed Yousef, MD
Rehana Shafi, MD
Husam I. Ardah, PhD
Ahmad Elwy, MD
Abdullah A. Alghamdi, MD
Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial
Critical Care Explorations
title Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial
title_full Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial
title_fullStr Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial
title_full_unstemmed Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial
title_short Optimizing Recovery: Early Versus Delayed Chest Tube Removal in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trial
title_sort optimizing recovery early versus delayed chest tube removal in pediatric cardiac surgery patients a randomized controlled trial
url http://journals.lww.com/10.1097/CCE.0000000000001271
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