Management and characteristics of significant Post-CABG pleural effusions requiring intervention and their clinical outcomes.

Abstract

Objective: To evaluate the characteristics, management approaches, and clinical outcomes of significant post-CABG pleural effusions, with emphasis on effusion type and predictors of intervention. Study Design: Retrospective Observational study. Setting: Peshawar Institute of Cardiology, Peshawar. Period: January 2024 to December 2025. Methods: A total of 100 post-cardiac surgery patients with clinically significant pleural effusions were included. Data on demographics, surgical details, pleural fluid characteristics, interventions, complications, and outcomes were extracted from electronic medical records and analyzed using descriptive statistics in SPSS version 23. Results: The cohort was predominantly male (75%) with a mean age of 58.30 ± 9.06 years. Most patients had moderate (64%) or large (32%) effusions. Transudative effusions predominated (74%), while 26% were exudative. Chest tube drainage was the most common intervention (74%). Procedure-related complications were uncommon (3%) but were significantly associated with exudative effusions (p = 0.047). Radiological lung expansion was achieved in 93% of patients. Conclusion: Post-CABG pleural effusions are predominantly transudative and can be managed safely with pleural drainage. Chest tube drainage remains the preferred approach, while exudative effusions warrant closer monitoring due to a higher complication risk.