Abstract
Purpose
Retrospective analysis of data to determine if the use of postoperative furosemide therapy decreases the incidence of thoracocentesis in children and adolescents undergoing kyphosis or scoliosis surgery. One of the potential complications seen in patients undergoing scoliosis or kyphosis surgery is the development of a clinically symptomatic postoperative pleural effusion requiring thoracocentesis, which is an invasive procedure that is associated with discomfort to the patient and a minimal risk of an iatrogenic pneumothorax.
Methods
We retrospectively reviewed the medical records and X-rays of 190 patients who had undergone corrective surgery for AIS/kyphosis. All patients underwent an ASF or an APSF or a PSF with a minimum 3 level costoplasty. We compared the rate of thoracocentesis in group 1 (no furosemide; 161 patients) to that in group 2 (furosemide; 29 patients). Follow-up chest radiographs were evaluated for a decrease or resolution of the effusion.
Results
In group 1, 26 out of the 161 patients required thoracocentesis (16%); in group 2, only 1 out of the 29 patients underwent thoracocentesis (3.4%).
Conclusions
Postoperative furosemide in patients who undergo significant pleural manipulation during spinal deformity surgery may decrease the incidence of clinically symptomatic pleural effusion requiring thoracocentesis. This study represents a true trend; however, a high level of significance can only be achieved by performing a larger randomized controlled study.
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References
Perez-Caballero Macarron C, Burgos Flores J, Martos Sanchez I et al (2006) Early postoperative complications after scoliosis surgery. An Pediatr (Barc) 64(3):248–251
Opacic M, Bilic A, Liubicic N et al (1991) Thoracocentesis under ultrasonographic control. Acta Med Iugosl 45(1):71–75
Koh DM, Burke S, Davies N et al (2002) Transthoracic US of the chest: clinical uses and applications. Radiographics 22(1):e1
Drolsum A, Skjennald A (1994) Percutaneous pleural and pericardial drainage. Tidsskr Nor Laegeforen 114(28):3324–3326
Rasmussen OS, Boris P (1989) Ultrasound guided puncture of pleural fluid collections and superficial thoracic masses. Eur J Radiol 9(2):91–92
Chakko SC, Caldwell SH, Sforza PP (1989) Treatment of congestive heart failure. Its effect on pleural fluid chemistry. Chest 95(4):798–802
Mouallem M, Brif I, Mavan H et al (1995) Prolonged therapy by the combination of furosemide and thiazide diuretics in refractory heart failure and other fluid retaining conditions. Int J Cardiol 50(2):89–94
Barnes TW, Morganthaler TI, Olson EJ et al (2005) Sonographically guided thoracocentesis and rate of pneumothorax. J Clin Ultrasound 33(9):442–446
Frederick M, Abrahamian DO (2001) Pleural effusion E Medicine Sept 2001. http://www.emedicine.medscape.com
Medicine plus—furosemide. Drug information. http://www.nlm.nih.gov/medlineplus/
Romero-Candeira S, Fernandez C, Sanchez-Pava J et al (2001) Influence of diuretics on the concentration of proteins and other components of pleural transudates in patients with heart failure. Am J Med 110(9):681–686
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Vora, V., Crawford, A. The role of postoperative furosemide therapy in the treatment of pleural effusion following kyphosis/scoliosis surgery. J Child Orthop 5, 283–287 (2011). https://doi.org/10.1007/s11832-011-0351-5
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DOI: https://doi.org/10.1007/s11832-011-0351-5