Chest tube clogging is more common than many people think. In a recent study, investigators found that 36% of adult cardiac surgery patients have completely clogged chest tubes, the majority of which aren’t visible in the external portion of the tube and therefore can’t be addressed6 When ICU nurses recognize clogging, which is manifested by strands of clot forming in the tubes, they often strip, tap or milk the tubes to attempt to break them up and keep the tubes flowing.3, 13, 18
Chest tube clogging tends to be more common in patients that have brisk postoperative bleeding, though there is no definitive indicator for which patients will have this complication. Many studies suggest that between 40% to 50% of patients after heart surgery have “excessive post-operative bleeding.” It is in these patients that maintaining chest tube drainage is imperative and challenging.
Experience suggests this is most common in the first 24 hours post op when the secretions and bloody discharge is thicker.
If the chest tubes clog, especially when there is bleeding, fluid can accumulate around the heart and in the pleural space around the lungs. This can lead to the need for a take back for wash out, replacement of the chest tubes, thoracentesis or pericardiocentesis. A nationwide analysis of cardiac surgery inpatients found that 17% have Retained Blood Syndrome (RBS), leading to an increase in length of stay, mortality, and hospital costs.15
PleuraFlow ACT comes with a specially calibrated silicone chest tube. This makes sure the clearance apparatus is sized properly to fit the length and diameter of the chest tube. For this reason, the PleuraFlow ACT cannot be used with other brands of chest tubes.
Yes, PleuraFlow ACT can be used with any drainage canisters by simply connecting the clearance apparatus to the drainage canister tubing.
Pre-clinical studies comparing PleuraFlow ACT to conventional chest tubes demonstrate that PleuraFlow ACT provides improved postoperative blood evacuation, resulting in less retained blood in the chest cavity.1, 12 Recent clinical data suggests PleuraFlow ACT reduces Retained Blood Syndrome (RBS) in patients recovering from heart surgery.16