What’s your ICU Chest Tube Patency Protocol?

How Leading Hospitals are Developing Protocols to Proactively Maintain Chest Tube Patency after Heart Surgery:  Improving outcomes and reducing hospital costs is a continual effort in modern healthcare. For heart surgery patients, a good place to start is by focusing on something that is common to nearly all recovering patients. All cardiac surgery patients have some degree of post-operative bleeding and chest tubes are required to evacuate this blood from the pleural and/or pericardial spaces in all patients.1,2 Chest tube clogging, which has been found to occur in 36% of heart surgery patients, can cause blood to be retained around the heart and lungs, which can lead to Retained Blood Syndrome

Improving Your Cardiac Program’s Bottom Line: Six Simple Steps to Recoup Lost RBS Costs After Heart Surgery

Bleeding is one of the most common and expensive complications after heart surgery. When a patient hemorrhages not only does it impact patient clinical outcomes, the hospital hemorrhages money in un-recouped costs to manage the ensuing complications. A big driver of these costs is Retained Blood Syndrome (RBS). Blood is evacuated by drainage systems in the early hours after surgery until the bleeding stops. RBS occurs when the blood evacuation is inadequate at evacuating shed blood.  A common cause of this is chest tube clogging which occurs when thrombus obstructs the inside of the drainage catheters placed around the heart and lungs in the early hours after heart surgery. The following are

Post Op Bleeding after heart surgery: Better out than in!

  All patients bleed in the early hours after heart surgery. The post-operative blood shed into the chest is drained through chest tubes and collected in drainage canisters. For some this is just a few hundred cc’s and then it stops. For others it can be more than a liter. In these early hours after surgery great efforts are taken to support the patient until coagulation is restored and bleeding subsides. In the recent era, the potential for bleeding has increased because of more liberal use of antiplatelet medications like Plavix, as well as more complex and often redo procedures. Some patients bleed more because the operation is urgent and

Leave No Clot Behind: The Role of Retained Clot in Post Operative Effusions After Cardiac Surgery

Drainage systems are used to evacuate blood from around the heart and lungs after cardiac surgery. If the drainage capacity exceeds the amount of bleeding, then the blood is fully evacuated. When the drainage capacity is impaired, for example by obstruction from chest tube clots, then blood is retained around the heart (pericardial space) and lungs (pleural spaces). Blood that is retained in these spaces cause a host of complications called Retained Blood Syndrome (RBS), often impairing patient recovery. Blood that pools turns to clot. What is the fate of these clots in the pleural and pericardial spaces? It depends on the volume and location. Large volume clots must be surgically evacuated in

The Cardiac Surgery RBS Dilemma

Heart surgeons and their teams are often faced with a dilemma: They put in and manage chest tubes to drain shed blood from around the heart and lungs after heart surgery. This is because all patients bleed for a few hours after heart surgery until they are stabilized in the ICU. But now it’s been shown that up to 36% of these chest tubes clot off in the early hours after surgery.1 When this happens, patients can retain blood around their heart and lungs, leading to Retained Blood Syndrome (RBS). RBS includes any interventions required to wash out, remove or drain blood clot, blood or bloody fluid after an initial cardiac surgery procedure. This