Chest Tube Selection in Cardiac and Thoracic Surgery: A Survey of Chest Tube‐Related Complications and Their Management

@article{Shalli2009ChestTS,
  title={Chest Tube Selection in Cardiac and Thoracic Surgery: A Survey of Chest Tube‐Related Complications and Their Management},
  author={Shanaz Shalli and Diyar Saeed and Kiyotaka Fukamachi and Alan Marc Gillinov and William E. Cohn and Louis P Perrault and Edward M. Boyle},
  journal={Journal of Cardiac Surgery},
  year={2009},
  volume={24}
}
Abstract  Background: Blood accumulating inside chest cavities can lead to serious complications if it is not drained properly. Because life‐threatening conditions can result from chest tube occlusion after thoracic surgery, large‐bore tubes are generally employed to optimize patency. Aims: The aim of this study was to better define problems with current paradigms for chest drainage. Materials and Methods: A survey was conducted of North American cardiothoracic surgeons and specialty cardiac… 
Incidence of chest tube clogging after cardiac surgery: a single-centre prospective observational study.
  • J. Karimov, A. Gillinov, +4 authors K. Fukamachi
  • Medicine
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 2013
TLDR
The status of urgency, reoperations and use of blood products can be contributing factors increasing the incidence of chest tube clogging, and Clinicians likely underestimate the prevalence of this failure to drain.
Does more than a single chest tube for mediastinal drainage affect outcomes after cardiac surgery?
TLDR
The use of multiple mediastinal chest tubes after cardiac surgery confers no advantage over a single chest tube in preventing return to the operating room for bleeding or tamponade.
Active clearance vs conventional management of chest tubes after cardiac surgery: a randomized controlled study
TLDR
The implementation of active clearance of chest tubes reduced re-exploration and chest tube clogging in patients after cardiac surgery further supporting recommendations to consider this modality postoperatively.
Novel Chest Tube Design to Alleviate Clogging and Facilitate Video-Assisted Thoracoscopic Surgery
TLDR
The novel CT design proposed by the authors aims to address issues with clogging by allocating side ports for frequent catheter suctioning and thoracoscopic instrumentation while keeping a sealed continuous suctioned.
Active clearance of chest tubes is associated with reduced postoperative complications and costs after cardiac surgery: a propensity matched analysis
TLDR
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.
Tamponade Relief by Active Clearance of Chest Tubes.
TLDR
A novel method of maintaining chest tube patency in the early recovery after cardiothoracic surgery is discussed, with the case of a patient with massive postoperative pericardial effusion with tamponade managed by active clearance chest tube.
Factors in the Selection and Management of Chest Tubes After Pulmonary Lobectomy: Results of a National Survey of Thoracic Surgeons.
TLDR
Patterns of chest tube selection and management after open lobectomy and minimally invasive lobectomy by thoracic surgeons are determined and clinical experience was the most important factor in determining their CT strategy.
The PleuraFlow Active Chest Tube Clearance System: Initial Clinical Experience in Adult Cardiac Surgery
TLDR
This device may be useful to allow caregivers to be certain that chest tubes are functioning in the early hours after surgery, when active bleeding is resolving and when complications from undrained blood can ensue.
Does size matter? A prospective analysis of 28–32 versus 36–40 French chest tube size in trauma
TLDR
For injured patients with chest trauma, chest tube size did not impact the clinically relevant outcomes tested and there was no difference in the efficacy of drainage, rate of complications including retained hemothorax, need for additional tube drainage, or invasive procedures.
Active clearance of chest drainage catheters reduces retained blood.
TLDR
ATC is associated with a reduced need for interventions for RBS and postoperative atrial fibrillation and underscores the importance of maintaining chest tube patency in the early hours after cardiac surgery.
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