{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:02:10Z","timestamp":1753876930396,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Chest drains are routinely placed in children following cardiac surgery. The purpose of this study was to determine the incidence of a clinically relevant pneumothorax and\/or pleural effusion after drain removal and to ascertain if a chest radiograph can be safely avoided following chest drain removal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This single-centre retrospective cohort study included all patients under 18\u2009years of age who underwent cardiac surgery between January 2015 and December 2019 with the insertion of mediastinal and\/or pleural drains. Exclusion criteria were chest drain\/s in situ \u226514\u2009days and mortality prior to removal of chest drain\/s. A drain removal episode was defined as the removal of \u22651 drains during the same episode of analgesia \u00b1 sedation. All chest drains were removed using a standard protocol. Chest radiographs following chest drain removal were reviewed by 2 investigators.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In all, 1076 patients were identified (median age: 292\u2009days, median weight: 7.8\u2009kg). There were 1587 drain removal episodes involving 2365 drains [mediastinal (n\u2009=\u20091347), right pleural (n\u2009=\u2009598), left pleural (n\u2009=\u2009420)]. Chest radiographs were performed after 1301 drain removal episodes [mediastinal (n\u2009=\u20091062); right pleural (n\u2009=\u2009597); left pleural (n\u2009=\u2009420)]. Chest radiographs were abnormal after 152 (12%) drain removal episodes [pneumothorax (n\u2009=\u200943), pleural effusion (n\u2009=\u200998), hydropneumothorax (n\u2009=\u200911)]. Symptoms\/signs were present in 30 (2.3%) patients. Eleven (&amp;lt;1%) required medical management. One required reintubation and 2 required chest drain reinsertion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The incidence of clinically significant pneumothorax\/pleural effusion following chest drain removal after paediatric cardiac surgery is low (&amp;lt;1%). Most patients did not require reinsertion of a chest drain. It is reasonable not to perform routine chest radiographs following chest drain removal in most paediatric cardiac surgical patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivad159","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T17:25:56Z","timestamp":1695662756000},"source":"Crossref","is-referenced-by-count":0,"title":["Utility of routine chest radiographs after chest drain removal in paediatric cardiac surgical patients\u2014a retrospective analysis of 1076 patients"],"prefix":"10.1093","volume":"37","author":[{"given":"Gautham","family":"Shetty","sequence":"first","affiliation":[{"name":"Queensland Paediatric Cardiac Service (QPCS), Queensland Children\u2019s Hospital , Brisbane, QLD, Australia"},{"name":"School of Medicine, Children's Health Queensland Clinical Unit, University of Queensland , Brisbane, QLD, Australia"},{"name":"Queensland Paediatric Cardiac Research, Children\u2019s Health Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Zouki","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldine","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-9035","authenticated-orcid":false,"given":"Aditya","family":"Patukale","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Cardiac Service (QPCS), Queensland Children\u2019s Hospital , Brisbane, QLD, Australia"},{"name":"School of Medicine, Children's Health Queensland Clinical Unit, University of Queensland , Brisbane, QLD, Australia"},{"name":"Queensland Paediatric Cardiac Research, Children\u2019s Health Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5855-1911","authenticated-orcid":false,"given":"Kim S","family":"Betts","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University , Perth, WA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert N","family":"Justo","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Cardiac Service (QPCS), Queensland Children\u2019s Hospital , Brisbane, QLD, Australia"},{"name":"School of Medicine, Children's Health Queensland Clinical Unit, University of Queensland , Brisbane, QLD, Australia"},{"name":"Queensland Paediatric Cardiac Research, Children\u2019s Health Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supreet P","family":"Marathe","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Cardiac Service (QPCS), Queensland Children\u2019s Hospital , Brisbane, QLD, Australia"},{"name":"School of Medicine, Children's Health Queensland Clinical Unit, University of Queensland , Brisbane, QLD, Australia"},{"name":"Queensland Paediatric Cardiac Research, Children\u2019s Health Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0416-7823","authenticated-orcid":false,"given":"Prem","family":"Venugopal","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Cardiac Service (QPCS), Queensland Children\u2019s Hospital , Brisbane, QLD, Australia"},{"name":"School of Medicine, Children's Health Queensland Clinical Unit, University of Queensland , Brisbane, QLD, Australia"},{"name":"Queensland Paediatric Cardiac Research, Children\u2019s Health Queensland , Brisbane, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"QPCR Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Suna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Karl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-8298","authenticated-orcid":false,"given":"Nelson","family":"Alphonso","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Cardiac Service (QPCS), Queensland Children\u2019s Hospital , Brisbane, QLD, Australia"},{"name":"School of Medicine, Children's Health Queensland Clinical Unit, University of Queensland , Brisbane, QLD, Australia"},{"name":"Queensland Paediatric Cardiac Research, Children\u2019s Health Queensland , Brisbane, QLD, 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surgery","volume":"112","author":"Tolsma","year":"2011","journal-title":"Anesth Analg"},{"key":"2023100720272702600_ivad159-B10","doi-asserted-by":"crossref","first-page":"F46","DOI":"10.1136\/adc.2005.091322","article-title":"Chest radiographs after removal of chest drains in neonates: clinical benefit or common practice?","volume":"92","author":"van den Boom","year":"2007","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2023100720272702600_ivad159-B11","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.pedhc.2011.09.003","article-title":"The routine use of chest radiographs after chest tube removal in children who have had cardiac surgery","volume":"27","author":"Woodward","year":"2013","journal-title":"J Pediatr Health Care"},{"key":"2023100720272702600_ivad159-B12","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1161\/CIRCULATIONAHA.117.029138","article-title":"Exposure to low-dose ionizing radiation from cardiac procedures and malignancy risk 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