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

Simon Maltais, Mary E. Davis, Nicholas A. Haglund, Louis Perrault, Sudhir S. Kushwaha, John M. Stulak, Edward M. Boyle

Research output: Contribution to journalArticle

6 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)704-709
Number of pages6
JournalASAIO Journal
Volume62
Issue number6
DOIs
StatePublished - Oct 1 2016

Keywords

  • bleeding
  • chest tube
  • re-exploration
  • ventricular assist device

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Fingerprint Dive into the research topics of 'Active Clearance of Chest Tubes Reduces Re-Exploration for Bleeding after Ventricular Assist Device Implantation'. Together they form a unique fingerprint.

  • Cite this

    Maltais, S., Davis, M. E., Haglund, N. A., Perrault, L., Kushwaha, S. S., Stulak, J. M., & Boyle, E. M. (2016). Active Clearance of Chest Tubes Reduces Re-Exploration for Bleeding after Ventricular Assist Device Implantation. ASAIO Journal, 62(6), 704-709. https://doi.org/10.1097/MAT.0000000000000437