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Evolving Care Pathways in Cardiac Surgery Recovery: The Expanding Focus on Drainology in Chest Drain Management

In the realm of cardiac surgery, advancements aren’t solely about the procedures performed within the operating room. They also extend to the meticulous care and management post-surgery, crucial for ensuring optimal patient outcomes. One groundbreaking subject that has been gaining momentum on the podiums at the surgical meetings such as the American Association of Thoracic Surgery

(AATS), European Society of Cardiothoracic Surgery (EACTS), the Asian Society of Cardiovascular and Thoracic Surgery (ASCVTS) or the Society of Thoracic Surgery (STS) in recent years is “drainology” – a term encapsulating a series of presentations and publications on the evolving strategies and technologies aimed at enhancing chest drain management following cardiac procedures. At the forefront of this paradigm shift is PleuraFlow, an innovative solution revolutionizing cardiac surgery recovery

Understanding Drainology: Enhancing Recovery Beyond the Operating Room

Traditionally, post-cardiac surgery recovery involved prolonged bed rest, limited mobility, and extended hospital stays. However, with the advent of enhanced recovery guidelines and fast track protocols now, drainology, is becoming a bigger part of the narrative. Drainology is a term now being used that represents a comprehensive approach to managing chest drainage systems, emphasizing protocols and evolved systems designed to expedite recovery, reduce complications, and ultimately, facilitate early patient discharge.

The core principles of drainology encompass optimizing drainage efficiency, minimizing complications such as postoperative atrial fibrillation (POAF), reducing the need for reoperations due to bleeding, and shortening hospital stays – all while maintaining cost-effectiveness. By focusing on these aspects, surgeons can facilitate quicker patient mobilization, earlier ambulation, and a smoother transition to home-based recovery.

Active Tube Clearance: The PleuraFlow Advantage

The utilization of advanced chest drainage systems equipped with active tube clearance mechanisms is an element often discussed when Drainology is presented at the meetings. Among these, PleuraFlow has reshaped the landscape of post- cardiac surgery care as it has the longest safety track record and the most data supporting its use. Unlike traditional chest drains, PleuraFlow integrates innovative technology to actively clear clots and debris from the chest tubes, ensuring optimal drainage efficiency.

PleuraFlow’s efficacy is underscored by its extensive track record, with over 100,000 successful implementations worldwide. Moreover, its regulatory approvals across various jurisdictions is evidence that regulatory bodies consider it a safe and effective device. Backed by over nine published clinical trials including randomized studies, Class I ERAS guidelines, and a meta-analysis, PleuraFlow has consistently demonstrated its ability to mitigate complications, including reducing the incidence of POAF, minimizing the need for surgical re-interventions, and significantly shortening hospital stays.

Advancing Patient Outcomes: The Impact of Drainology in Cardiac Surgery

The adoption of drainology principles, coupled with innovative solutions like PleuraFlow, has ushered in a new era of enhanced cardiac surgery recovery. By prioritizing better drainage and early mobilization and expedited discharge, patients experience improved outcomes and enhanced quality of life post-surgery. Moreover, the reduction in complications and hospital length of stay translates to substantial cost savings for healthcare systems.

Beyond the clinical benefits, drainology embodies a patient-centric approach that prioritizes comfort, autonomy, and faster return to normalcy. By empowering patients to engage in their recovery journey actively, drainology fosters a sense of agency and confidence, which are instrumental in achieving successful long-term outcomes.

Conclusion

In the realm of cardiac surgery, the evolution of drainology represents a transformative shift towards optimizing postoperative care and enhancing patient recovery. Through innovative solutions like PleuraFlow, surgeons and ICU nurses are equipped with tools that not only improve clinical outcomes but also redefine the patient experience. As the field continues to embrace these advancements, the future of cardiac surgery recovery promises to be characterized by swifter rehabilitation, reduced complications, and ultimately, improved quality of life for patients worldwide.

 

Clinical Study References:
  1. Sirch J, Ledwon M, Püski T, Boyle EM, Pfeiffer S, Fischlein Active clearance of chest drainage catheters reduces retained blood. J Thorac Cardiovasc Surg. 2016;151(3):832- 838.e2.
  2. Maltais S, Davis ME, Haglund NA, et Active clearance of chest tubes reduces re- exploration for bleeding after ventricular assist device implantation. ASAIO J. 2016;62(6):704-709.
  3. St-Onge S, Ben Ali W, Bouhout I, et Examining the impact of active clearance of chest drainage catheters on postoperative atrial fibrillation. J Thorac Cardiovasc Surg. 2017;154(2):501-508.
  4. Grieshaber P, Heim N, Herzberg M, Niemann B, Roth P, Boening Active chest tube clearance after cardiac surgery is associated with reduced reexploration rates. Ann Thorac Surg. 2018;105(6):1771-1777.
  5. Baribeau Y, Westbrook B, Baribeau Y, et Active clearance of chest tubes is associated with reduced postoperative complications and costs after cardiac surgery: a propensity matched analysis. J Cardiothorac Surg. 2019;14(1):192.
  6. St-Onge S, Chauvette V, Hamad R, et al. Active Clearance vs conventional management of chest tubes after cardiac surgery: a randomized controlled J Cardiothorac Surg. 2021. 16:44.
  7. Hasan M, Hagrass A, Elkhrashy M, et Effectiveness of Active Chest Tube Clearance Versus Conventional Chest Tube in Reducing Postoperative Complications After Cardiac Surgery: a Systematic Review and Meta-analysis. SN Comprehensive Clinical Medicine. 2022. 4:177.
  8. Engleman DT, Ben Ali W, Williams JB, et al. Guidelines for preoperative care in cardiac surgery: Enhanced recovery after surgery society JAMA Surg. 2019; 154: 755-766.
  9. Grant M, Crisafi C, Alvarez A, et al. Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS). Ann Thorac Surg. 2023

Disclaimer: The views and opinions expressed here are those of the authors and do not necessarily represent the official policy or position of ClearFlow, Inc.