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.

Resources

PleuraFlow ACT Product Information

PleuraFlow Active Clearance Technology System

PleuraFlow technology has been optimized to deliver additional power with the push of a button.

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PleuraFlow® Instructions for Use - English Only

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Clinical Support

PleuraFlow ACT OR Training Module (TN116-A)

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PleuraFlow ACT ICU Training Module (TN117-A)

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PleuraFlow ACT ICU Training Worksheet (TN118-A)

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PleuraFlow ACT System Configuration Guide

Visual representations of common configurations of PleuraFlow and conventional chest tubes with drainage tubing and canister.

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PleuraFlow System Assemble

Guide Tube Removal

Magnet Strength Button Activation

Magnetic Release Safety Feature

Channel/Blake Drain Keycard

“The Facts” About Channel/Blake Drains

Updated: November 7, 2017

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Milking & Stripping Keycard

“The Facts” About Milking And Stripping

Updated: November 7, 2017

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Head of Bed PleuraFlow System Sign

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Head of Bed (Stepdown) PleuraFlow System Sign

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General Resource Files

Active clearance vs conventional management of chest tubes after cardiac surgery: a randomized controlled study

In this RCT, 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. (St-Onge, et al, 2021)

Updated: March 24, 2021

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Effectiveness of Active Chest Tube Clearance Versus Conventional Chest Tube in Reducing Postoperative Complications After Cardiac Surgery: a Systematic Review and Meta‑analysis

The clinical findings from this systematic review support the usage of ATC (Active Tube Clearance). It also revealed that ATC improves the clinical conditions of cardiac patients and reduces post-surgery complications compared to CT.

Updated: July 15, 2022

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

Reduction of patient complications and hospital resource utilization after heart surgery demonstrated with use of the PleuraFlow ACT System. (Baribeau, et al, 2019)

Updated: November 14, 2019

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Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations

Enhanced Recovery After Surgery (ERAS) evidence-based protocols for perioperative care can lead to improvements in clinical outcomes and cost savings. This article aims to present consensus recommendations for the optimal perioperative management of patients undergoing cardiac surgery. (Daniel T. Engelman, MD, et al, 2019)

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Examining the impact of active clearance of chest drainage catheters on postoperative atrial fibrillation

Postoperative atrial fibrillation (POAF) is one of the most frequent complications encountered after heart surgery, and significantly increases complications and mortality. (St. Onge, et al, 2017)

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Active Clearance of Chest Tubes Reduces Re-Exploration for Bleeding After Ventricular Assist Device Implantation

Chest tubes are utilized to evacuate shed blood after left ventricular assist device (LVAD) implantation, however, they can become clogged, leading to retained blood. We implemented a protocol for active tube clearance (ATC) of chest tubes to determine if this might reduce interventions for retained blood. (Maltais, 2016)

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Pericardial Blood as a Trigger for Postoperative Atrial Fibrillation After Cardiac Surgery

Prevention strategies have long been sought to reduce the incidence and burden of postoperative atrial fibrillation (POAF) after heart surgery. (St-Onge, 2017)

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Active Chest Tube Clearance After Cardiac Surgery Is Associated With Reduced Reexploration Rates

Active tube clearance is associated with reduced reexploration rates in an all-comers collective undergoing cardiac surgery. Reexploration is the only RBS component relevant for mortality.

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Systematic review and meta-analysis of randomized controlled trials assessing safety and efficacy of posterior pericardial drainage in patients undergoing heart surgery

Review of 19 randomized controlled trials published in the Journal of Thoracic and Cardiovascular Surgery. Showed post pericardial drainage is safe and effective technique associated with a reduction in tamponade, early and late pericardial effusions, POAF and hospital stay. These benefits, in turn, translate into improved survival after heart surgery. (Gozdek, 2017)

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Outcome after procedures for retained blood syndrome in coronary surgery

A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively. Conclusion was that patients requiring any procedure for blood removal from pericardial and pleural spaces is associated with an increased risk of severe complications after isolated CABG. (Tauriainen, 2017)

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Impact of Retained Blood Requiring Reintervention on Outcomes After Cardiac Surgery

Study published in Journal of Thoracic and Cardiovascular Surgery which reviewed patient complications in pleural and pericardial cavities after cardiac surgery. Found statistically significant increases in mortality, hospital and ICU LOS, time of ventilation, and incidence of hemolysis in patients with retained blood interventions due to incomplete evacuation of shed blood. (Balzer, 2016)

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Tamponade Relief by Active Clearance of Chest Tubes

This is a case report of a patient who developed a tamponade in the ICU while recovering from heart surgery. The tamponade was recognized, and captured on Echo imaging. The patient had a PleuraFlow, so they actuated it a few times, and a clot was removed, and a gush of blood drained. The patient’s condition greatly improved, and the tamponade disappeared on Echo. (Vistarini, 2016)

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Retained Blood Syndrome After Cardiac Surgery: A New Look at an Old Problem

Retained post surgical blood, known as Retained Blood Syndrome (RBS), occurs in 1 in 5 patients and results in the need for invasive post-op re-interventions for tamponade and/or hemothorax in the acute setting, pericardial and/or pleural effusions subacutely, or fibrosis in the chronic setting. (Boyle. 2015)

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Active clearance of chest drainage catheters reduces retained blood

Active tube clearance reduces interventions for retained blood syndrome and postoperative atrial fibrillation, underscoring the importance of maintaining chest tube patency after cardiac surgery. (Sirch. 2015)

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Hemoglobin-associated oxidative stress in the pericardial compartment of postoperative cardiac surgery patients

Study that showed that retained blood in the pericardium leads to an intense, local pro-oxidant, pro-inflammatory response that may damage the pericardial environment and contribute to the development of POAF. (Kramer.2015)

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Superior Chest Drainage With an Active Tube Clearance System

Evaluation of a Downsized Chest Tube, published in The Annals of Thoracic Surgery (Arakawa. 2010)

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To Strip or Not to Strip?

To Strip or Not to Strip? Physiological Effects of Chest Tube Manipulation, published in the American Journal of Critical Care (Halm. 2007)

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Incidence of chest tube clogging after cardiac surgery

Incidence of chest tube clogging after cardiac surgery: a single-centre prospective observational study, published in the European Journal of Cardio-Thoracic Surgery (Karimov. 2013)

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Prevalence and Clinical Course of Pleural Effusions at 30 Days after Coronary Artery and Cardiac Surgery

Prevalence and Clinical Course of Pleural Effusions at 30 Days after Coronary Artery and Cardiac Surgery, published in the American Journal of Respiratory and Critical Care Medicine (Light. 2002)

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The PleuraFlow Active Chest Tube Clearance System Initial Clinical Experience in Adult Cardiac Surgery

The PleuraFlow Active Chest Tube Clearance System Initial Clinical Experience in Adult Cardiac Surgery, published in the International Society for Minimally Invasive Cardiothoracic Surgery (Perrault. 2012)

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Chest Tube Selection in Cardiac and Thoracic Surgery

Chest Tube Selection in Cardiac and Thoracic Surgery: A Survey of Chest Tube-Related Complications and Their Management (Shalli. 2009)

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Improved drainage with active chest tube clearance

Improved drainage with active chest tube clearance, published in Interactive CardioVascular and Thoracic Surgery (Shiose. 2010)

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Quality Management System to IS EN ISO 13485:2016

ClearFlow, Inc. has been assessed and deemed to comply with the requirements of the above standard in respect of the scope of operations given below: The design, manufacture and distribution of sterile, disposable chest drainage catheters and systems.

Effective Date: July 06, 2024 Expiry Date: July 05, 2027

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MDSAP Certificate

Australia, Brazil, Canada, USA: ClearFlow, Inc. has been assessed and deemed to comply with the requirements of the above standard and regulations in respect of the scope of operations given below: The design, manufacture and distribution of sterile, disposable chest drainage catheters and systems.

Effective Date: July 06, 2024 Expiry Date: July 05, 2027

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Quality System Approval Certificate Medical Devices Directive 93/42/EEC

CE Marking - CE Quality System Approval Certificate from NSAI for the PleuraFlow System through December 2028.

Effective Date: May 08, 2024 Expiry Date: December 31, 2028

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What is Retained Blood Syndrome (RBS)?

Retained Blood Syndrome: An Overview

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Retained Blood Causes & Complications

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Recovery is Beautiful®

Press Release: FDA Expands Label Indication for PleuraFlow to Reduce Retained Blood

The US FDA has expanded the Indications for Use for the PleuraFlow Active Clearance Technology System to be used in all cardiothoracic surgery and chest trauma procedures for adult and pediatric patients.

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Press Release: Clinical Investigators at German Anesthesia Congress Report Increased Stays in ICU Press Release: Related to Retained Blood Syndrome After Cardiac Surgery

Critical care investigators presented data last week at the 62nd annual German Anesthesia Congress (DAC 2015) in Düsseldorf, Germany about outcomes in patients who develop Retained Blood Syndrome (RBS) from incomplete blood evacuation after cardiac surgery.

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Press Release: Surgeons Discuss High Readmission Rates for Patients with Retained Blood Syndrome After Cardiac Surgery

Leading Clinical Experts Share Experiences at ClearFlow-Hosted Symposium as Company's PleuraFlow® Active Clearance Technology® is displayed at AATS.

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Study Demonstrates Concern for Retained Blood Syndrome after Heart Surgery

ClearFlow Executives Comment on New Data

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Press Release: ClearFlow announces positive clinical trial results for the reduction of hospital complications after heart surgery

ClearFlow announces positive clinical trial results for the reduction of hospital complications after heart surgery; Washington, DC.—October 10, 2014—

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Value Analysis Committee (VAC) Presentation 2022 – White

Presentation on Reducing Costs and Complications for Your Cardiac Surgery Patients

June 7, 2022

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Value Analysis Committee (VAC) Presentation 2022 – Branded

Presentation on Reducing Costs and Complications for Your Cardiac Surgery Patients

June 7, 2022

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Download the ClearFlow Assistant Mobile Support Experience