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Journal of Cardiothoracic Surgery

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Open Access 01-12-2019 | Heart Surgery | Research article

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

Authors: Yvon Baribeau, Benjamin Westbrook, Yanick Baribeau, Simon Maltais, Edward M. Boyle, Louis P. Perrault

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

Abstract

Background

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.

Methods

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.

Results

Propensity matched patients in Phase 2 had a reduced need for drainage procedures for pleural effusions (22% vs. 8.1%, p < 0.001) and reduced postoperative atrial fibrillation (37 to 25%, P = 0.011). This corresponded with fewer hours in the ICU (43.5 [24–79] vs 30 [24–49], p = < 0.001), reduced median postoperative length of stay (6 [4–8] vs 5 [4–6.25], p < 0.001) median costs reduced by $1831.45 (− 3580.52;82.38, p = 0.04) and the mean costs reduced by an average of $2696 (− 6027.59;880.93, 0.116).

Conclusions

This evidence supports the concept that efforts to actively maintain chest tube patency in early recovery is useful in improving outcomes and reducing resource utilization and costs after cardiac surgery.

Trial registration

Clinicaltrial.gov, NCT02145858, Registered: May 23, 2014.

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Title: Active clearance of chest tubes is associated with reduced postoperative complications and costs after cardiac surgery: a propensity matched analysis
Authors: Yvon Baribeau
Benjamin Westbrook
Yanick Baribeau
Simon Maltais
Edward M. Boyle
Louis P. Perrault
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Heart Surgery
Acute Kidney Injury
Pleural Effusion
Care
Heart Surgery
Atrial Fibrillation
Acute Kidney Injury
Published in: Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-019-0999-3

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

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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