WEBINAR REPLAY: "Chest Tube Management in Cardiac Surgery" | ERAS Cardiac Society Webinar in collaboration with CTSNet

Key speakers Marc Gillinov, MD, Jurij M. Kalisnik, MD, and Lenard Conradi, MD discuss the clinical implications of retained blood, current strategies in chest tube management, and the benefits of posterior pericardiotomy.
Webinar moderated by Kevin Lobdell, MD, and Marc Gerdisch, MD.


Open Chest Tube Clearance of Clot: Is it safe? Is there a better way?

Chest tubes are required for all heart operations to evacuate shed blood from around the heart and lungs. Evidence suggests that nearly 36% of chest tubes can clog, preventing adequate blood evacuation and potentially leading to retained blood syndrome (RBS). But how do you keep chest tubes free of clot and working to evacuate shed blood? There are currently no published national standards, and thus nurses and ICU…

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The Challenges of Keeping a Chest Tube Free of Clogging after Heart Surgery

Chest tubes are used on every case after heart surgery to drain blood from around the heart and lungs in the early hours of recovery.1,2  If there is any bleeding, or even oozing tissues, the blood must be immediately drained externally by the chest tubes. But chest tubes frequently clot, which can lead to Retained Blood Syndrome (RBS), which includes the need for re-interventions to wash out clot,…

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It’s Time to Proactively Address your Cardiac Surgery Program MIPS and APM Goals

Healthcare reimbursement for physicians and hospitals is evolving rapidly in the United States. In 2015, Congress replaced the broken SGR reimbursement system with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to reward healthcare quality and lower costs while at the same time, migrating away from traditional fee for service payment models. Hospitals have been waiting to hear how this will be implemented. In late April…

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Three Practices to Speed Patient Recovery by Reducing RBS after VAD Implantation

Today, ventricular assist devices (VAD) are routinely used to partially or completely replace the function of a failing heart.1 While this good news for patients with advanced heart failure, there are still significant risks involved – particularly short-term complications that continue to threaten major morbidity. Yet by implementing a few simple but crucial protocols, you may be able to greatly speed recovery, lower the costs of care, and…

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RBS: Harnessing the Power of Lean Six Sigma to Reduce Costs and Complications of Chest Tube Clogging

All stakeholders in healthcare want to see improved outcome and reduced costs to maximize patient value. The question is how to get there? As promising new technologies and protocols are innovated and become known, the questions are always the same: “How do we know this works?” “Is it worth it to make the changes in protocols needed to figure this out?” “Is there return on investment given the…

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Retained Blood Syndrome Leads to Impaired Cardiac and Respiratory Recovery

Bleeding is common after heart surgery. Patients with bleeding after heart surgery clearly have worse outcomes. But why? Theoretically, if a patient is bleeding and the chest tubes adequately drain the blood from around the heart and lungs while coagulation is restored and the blood products replaced, there should not be much impact on outcomes. But this is clearly not the case. For example in a recent study by Chistensen and…

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Leave No Clot Behind Part 2: Preventing Retained Blood Reduces Post Op Atrial Fib (POAF)

Chest tubes are used to prevent retained clot around the heart in patients recovering from heart surgery. Chest tubes often fail by clogging, leading to retained blood syndrome.1, 2 Growing evidence suggests that retained blood is one of the most potent triggers for developing Post Operative Atrial Fibrillation (POAF).3 POAF is the most common complication after Cardiac Surgery, leading to longer and more expensive hospital stays, readmissions and…

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