FAQ

How often does chest tube clogging occur?

• Chest tube clogging is more common than many people think. In a recent study, investigators found that 36% of adult cardiac surgery patients have clogged chest tubes, the majority of which aren’t visible in the external portion of the tube and therefore can’t be addressed. When ICU nurses recognize clogging, whichc 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. (1)

Are there patient populations where chest tube clogging is more common?

• 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.

Are there certain times when chest tube clogging is more likely to happen?

• Experience suggests this is most common in the first 24 hours post op when the secretions and bloody discharge is thicker.

How often does chest tube clogging impact outcomes?

• 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 complex, leading to an increase in length of stay, mortality, and hospital costs.

Can the PleuraFlow be used with any chest tube?

• The PleuraFlow ACT system comes with a specially calibrated, soft silicone chest tubes. This makes sure the clearance apparatus is sized properly to fit the chest tube. For this reason, the PleuraFlow ACT cannot be used with other brands of chest tubes.

Can the PleuraFlow be used with any chest drainage canister?

• Yes, PleuraFlow ACT systems can be used with any drainage canisters by simply connecting the clearance apparatus to the drainage tubing to the canister.

Does the PleuraFlow improve postoperative blood evacuation over conventional chest tubes?

• Pre-clinical studies comparing the PleuraFlow ACT System to conventional chest tubes demonstrate that PleuraFlow ACT provides improved postoperative blood evacuation, resulting in less retained blood in the chest cavity.(3, 4)

1. Karimov, J.H., Gillinov, A. M., Schenck, L., Cook, M., Kosty Sweeney, D., Boyle, E.M., Fukamachi, K. . Incidence of chest tube clogging after cardiac surgery: A single-center prospective observational study. Eur J Cardiothorac Surg. In Press.
2. Herman CR, Buth KJ, Kent BA, Hirsch GM. Clopidogrel increases blood transfusion and hemorrhagic complications in patients undergoing cardiac surgery. Ann Thorac Surg 2010;89:397-402.
3. Arakawa, Yoko; Shiose, Akira; Takaseya, Tohru; Fumoto, Hideyuki; Kim, Hyun-Il; Boyle, Edward M.; Gillinov, A. Marc; Fukamachi, Kiyotaka. “Superior Chest Drainage With an Active Tube Clearance System: Evaluation of a Downsized Chest Tube.” Ann Thorac Surg 91 (2): 580–583.
Shiose, A.; Takaseya, T.; Fumoto, H.; Arakawa, Y.; Horai, T.; Boyle, E. M.; Gillinov, A. M.; Fukamachi, K. “Improved drainage with active chest tube clearance.” Interactive CardioVascular and Thoracic Surgery 10 (5): 685–688.