Abstract |
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. A total of 252 patients underwent LVAD implantation. Seventy-seven patients had conventional chest tube drainage (group 1), whereas 175 patients had ATC (group 2). A univariate and multivariate analysis adjusting for the use of conventional sternotomy (CS) and minimally invasive left thoracotomy (MILT) was performed. Univariate analysis revealed a 65% reduction in re-exploration (43-15%, p < 0.001), and an 82% reduction in delayed sternal closure (DSC; 34-6%, p <0.001). In a sub-analysis of CS only, there continued to be statistically significant 53% reduction in re-exploration (45% vs. 21%, p = 0.0011), and a 77% reduction in DSC (35% vs. 8%, p < 0.001) in group 2. Using a logistic regression model adjusting for CS versus MILT, there was a significant reduction in re-exploration (odds ratio [OR] = 0.44 [confidence interval {CI} = 0.23-0.85], p = 0.014) and DSC (OR = 0.20 [CI = 0.08-0.46], p <0.001) in group 2. Actively maintaining chest tube patency after LVAD implantation significantly reduces re-exploration and DSC.
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Authors | Simon Maltais, Mary E Davis, Nicholas A Haglund, Louis Perrault, Sudhir S Kushwaha, John M Stulak, Edward M Boyle |
Journal | ASAIO journal (American Society for Artificial Internal Organs : 1992)
(ASAIO J)
2016 Nov/Dec
Vol. 62
Issue 6
Pg. 704-709
ISSN: 1538-943X [Electronic] United States |
PMID | 27556153
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Chest Tubes
- Female
- Heart-Assist Devices
(adverse effects)
- Hemorrhage
(etiology)
- Humans
- Logistic Models
- Male
- Middle Aged
- Sternotomy
- Thoracotomy
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