Key Points
- To describe the clinical features, fluid characteristics, and management outcomes of large pleural effusions following coronary artery bypass grafting.
- Retrospective case series reviewing chest radiographs, pleural fluid analyses, and surgical records from 3,707 patients who underwent CABG between February 1996 and August 1997 at a tertiary teaching hospital.
- Large pleural effusions occupying over 25% of the hemithorax occurred in 29 patients (0.78%), with 27 presenting primarily on the left side.
- Identified causes included congestive heart failure (n=7), pericarditis (n=2), and pulmonary embolism (n=1), while 19 cases had an unclear etiology.
- Of the 19 unexplained cases, bloody effusions (n=8) appeared earlier with higher lactic acid dehydrogenase and eosinophilia responding to thoracenteses, whereas nonbloody effusions (n=11) required more complex interventions.
Structured PICO
PPopulation3707 patients who had coronary artery bypass grafting (CABG) between 1 February 1996 and 1 August 1997 at a tertiary care teaching hospital.
OOutcomeClinical course and pleural fluid findings of large pleural effusions (>25% of hemithorax) occurring after CABG
Large pleural effusions are a rare (0.78%) complication after CABG, often of unclear etiology, with bloody effusions typically occurring earlier and nonbloody effusions being more difficult to manage.