diuresing from chest tube

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Specializes in Critical Care/CVICU.

Hi all,

I am a new grad in cardiac surgery ICU and something interesting came up the other day I've never heard of before (granted there are lots of things I've never heard of being I am new to this world). A patient had a complicated open heart surgery and has had mediastinal chest tubes in for ~7 days and the tube is still having significant output (40-100ml/hr). The CT surgeon has said this is good because the patient is diuresing through the chest tube. The drainage is still serosanguineous. Is this common? I tried a quick google search but nothing came relevant popped up.

Thanks in advance!

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Specializes in Critical Care.

No that's not common, seeing 40-100ml per hour of S/S drainage 7 days after OHS as a "good" thing is impressive optimism. Typically you would expect mediastinal or mediastinal/pleural drainage after OHS to drop to less than 100ml per 8 hour period by day 2 or 3. Fluid overload can increase the 'leaking' of serous fluid into the space drained by the CT, but not nearly enough to explain that rate and type of drainage.

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Specializes in Critical Care/CVICU.

Yes, that's why i was concerned, because most patients have their tubes out by POD 2 or 3 as the drainage has dwindled down by that point. Some nurses on my unit said they had heard of "diuresing" through the chest tubes before and some said that it was baloney. Thanks for the reply!

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Specializes in CICU, Telemetry.

I mean, it's good in that it's better to have up to 2400mL of volume in chest tube output than in the mediastinal space...

And technically it's volume that's leaving the body, so if you're looking at fluid balance on the grand scale, I suppose...

But the word diuresis literally means 'through urine', if you look at the word origins, so unless they're peeing out of their chest tubes, in which case I think you have a much bigger problem on your hands, I don't think it's 'technically' diuresis.

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He's taking poetic license with the word "diuresing". It begs the question of what his kidneys are doing. Sounds like a lymph leak.

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