Active clearance of chest tubes is associated with reduced postoperative complications and costs after cardiac surgery: a propensity matched analysis

Chest tubes are routinely used to evacuate shed mediastinal blood in the critical care setting in the early hours after heart surgery. Inadequate evacuation of shed mediastinal blood due to chest tube clogging may result in retained blood around the heart and lungs after cardiac surgery. The objecti...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2019-11, Vol.14 (1), p.192-192, Article 192
Main Authors: Baribeau, Yvon, Westbrook, Benjamin, Baribeau, Yanick, Maltais, Simon, Boyle, Edward M, Perrault, Louis P
Format: Article
Language:English
Subjects:
Aged
Analysis
Atrial fibrillation
Cardiac patients
Cardiac surgery
Cardiac Surgical Procedures
Chest tube
Chest Tubes
Costs
Critical care
Drainage - economics
Drainage - instrumentation
Drainage - methods
Female
Fibrillation
Health care costs
Hospital Costs - statistics & numerical data
Hospital patients
Humans
Male
Middle Aged
New Hampshire
Pleural effusion
Postoperative atrial fibrillation
Postoperative complications
Postoperative Complications - economics
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Propensity Score
Prospective Studies
Retrospective Studies
Treatment Outcome
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Summary:Chest tubes are routinely used to evacuate shed mediastinal blood in the critical care setting in the early hours after heart surgery. Inadequate evacuation of shed mediastinal blood due to chest tube clogging may result in retained blood around the heart and lungs after cardiac surgery. The objective of this study was to compare if active chest tube clearance reduces the incidence of retained blood complications and associated hospital resource utilization after cardiac surgery. Propensity matched analysis of 697 consecutive patients who underwent cardiac surgery at a single center. 302 patients served as a baseline control (Phase 0), 58 patients in a training and compliance verification period (Phase 1) and 337 were treated prospectively using active tube clearance (Phase 2). The need to drain retained blood, pleural effusions, postoperative atrial fibrillation, ICU resource utilization and hospital costs were assessed. Propensity matched patients in Phase 2 had a reduced need for drainage procedures for pleural effusions (22% vs. 8.1%, p 
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-019-0999-3