Mediastinal chest sump tubes following cardiac surgery: an unconventional method.

The practice of using conventional mediastinal chest tubes (MCTs) connected to a closed collection device is commonplace in cardiovascular surgery care settings. The MCT collection device requires a closed system to maintain a negative intrathoracic pressure with the goal of preventing inadvertent trapping of air and blood within the mediastinal space. Despite the proposed integrity of the closed system, there is no guarantee that the suction's negative pressure will prevent cardiac tamponade. In addition, it has been postulated that the required negative intrathoracic suction may potentiate mediastinal tissue damage. This clinical paper will describe the use of multi-lumen MCTs open to atmosphere following surgical repair for congenital heart defects. It is postulated that open MCTs may potentially reduce the risks of cardiac tamponade and mediastinal tissue damage. Through case presentation, the mechanics of open MCTs, nursing care, and possible complications will be delineated.