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What’s your Protocol?

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Proactive Protocols to Reduce Complications After Cardiac Surgery Improving outcomes and reducing 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 patients recovering. All cardiac surgery patients have some degree of bleeding postoperatively, and chest tubes are used to evacuate this blood from the pleural and/or pericardial spaces. Studies have shown that higher chest tube output is statistically associated with longer ICU stays, more complications, higher costs, and a greater risk of mortality. (1, 2) The tipping point in terms of patient outcomes occurs early in the recovery period, within the first six hours postoperatively, and when total chest tube output exceeds 200mL in any … [Read more...]

Stripping: It’s What You Don’t See That Should Concern You

Chest Tube Stripping

At the end of every open-heart surgery, surgeons place chest tubes in the surgical spaces to evacuate any post-surgical blood and/or fluid until normal coagulation is restored and hemostasis is achieved. The goal is to evacuate as much of the blood from these spaces as possible before the chemically thinned blood undergoes the phase change from liquid to solid as the coagulation system is restored. Any blood that is not effectively evacuated will naturally turn to clot, which the body then has to break down in a process called lysis. Depending on the volume of blood clot retained, this process can cause additional clinical complications that can last for weeks or months, and is a leading cause of hospital readmission. Therefore, the challenge for post-op care staff is to get the … [Read more...]

Chest Tube Clogging is Associated with Significantly Higher Rates of A-Fib and Other Hospital Complications

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Chest tubes clog after cardiac surgery. This is a known fact that has been acknowledged by 100% of surgeons surveyed, most of whom also report seeing serious adverse complications associated with clogged chest tubes.(1) When chest tubes clog in the presence of post-surgical bleeding, the evacuation of blood from around the heart and lungs can be impaired. This can lead to retained blood complex (RBC), which is a common cause for hospital readmission. But until now, the incidence of chest tube clogging after cardiac surgery has not been known. In a recently published prospective, single center study from the Cleveland Clinic, investigators inspected the chest tubes of 100 cardiac surgery patients and found that 36% of these patients had clogged chest tubes.(2) Clogging was significantly … [Read more...]

Blake Drains Can Cause RBC

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For years, surgeons have been trying to improve the evacuation of post cardiac surgery blood to prevent retained blood complex (RBC). Various permutations of suction drains (anticoagulant coatings, sump-style drains) have been tried, but the problem still remains that the single central lumen clogs with clot and impairs evacuation. (1-3) When this happens, acute complications can ensue, or sub-acute complications can result that slow recovery and contribute to readmissions. Unsatisfied with conventional single lumen drainage tubes that frequently clotted off, cardiac surgeons started to explore different drain geometries with the hope of improving evacuation. Channel, or Blake drains, have multiple open channels inside the patient (AB), transition to a closed off section (BC), and … [Read more...]

Job Opportunity: Clear Catheter Systems Seeks Clinical Specialists

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  Clear Catheter Systems is a Bend, Oregon based medical device company pioneering clearable catheter systems to solve the clinical problems caused by internally obstructed medical tubes. The company’s proprietary Active Clearance Technology™ (ACT) is being developed for a platform of surgical catheter systems. Clear Catheter System’s lead product is the PleuraFlow® ACT system, an award winning technology developed by cardiothoracic surgeons that has been proven to improve thoracic drainage. Clear Catheter is seeking clinical specialists to provide technical and clinical training and sales support. If you have a passion for patient care, solid clinical competency, are a self-motivator and thrive in a fast-paced environment, this is an ideal position for you. Sound like a … [Read more...]

Just a Passing Phase?

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All patients have post-surgical bleeding in the early hours after heart surgery. Some patients, depending on the extent of the surgery, comorbidities, or the use of preoperative anti-platelet drugs like Plavix , bleed more extensively than others. Studies have shown that the volume and rate of postoperative bleeding is strongly correlated with negative outcomes.(1, 2) Most of the time, the duration of bleeding is related to how long it takes for a patient’s coagulation system to kick back in after surgery. The nature of open-heart surgery requires that patients be anti-coagulated, cooled, and have their blood run through a heart-lung bypass machine. Combined, all of these impact the ability to form clot in the early hours after heart surgery. After surgery, patients will … [Read more...]

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