Department of Thoracic and Cardiovascular Surgery, University Hospital Göttingen, Georg-August University, Goettingen, Germany.
Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.
Interact Cardiovasc Thorac Surg. 2020 Jul 1;31(1):42-47. doi: 10.1093/icvts/ivaa049.
The use of digital chest drainage units (CDUs) has become increasingly common in thoracic surgery due to several advantages. However, in cardiac surgery, its use is still limited in favour of conventional analogue CDUs. In order to investigate the potential benefit of digital CDUs in cardiac surgery, we compared the safety and efficacy of both systems in patients undergoing cardiac surgery at our centre.
We retrospectively investigated 265 consecutive patients who underwent cardiac surgery at our institution between June 2017 and October 2017. These patients were divided into 2 groups: patients with analogue (A, n = 65) and digital CDUs (D, n = 200). Postoperative outcome was analysed and compared between both groups. In addition, the 'user experience' was evaluated by means of a questionnaire.
The median age of the cohort was 70 years (P = 0.167), 25.3% of patients were female (P = 0.414). There were no differences in terms of re-explorative surgery or use of blood products. Nor was there a difference in the overall amount of fluid collected. However, during the first 6 h, more fluid was collected by the digital CDUs. The overall rate of technical failure was 0.4%. We observed a significantly higher rate of clotting in the tubing system of the digital CDUs (P = 0.042). Concerning the user experience, the digital CDUs were associated with a more favourable ease of use on the regular wards (P < 0.001). With regard to the overall user experience, the digital CDUs outperformed the analogue systems (P = 0.002).
Digital CDUs can be safely and effectively applied in patients after cardiac surgery. Due to the improved patient mobility and simplified chest tube management, the use of digital CDUs may be advantageous for patients after cardiac surgery. However, the issue of clotting of the tubing systems should be addressed by further technical improvements.
由于数字胸腔引流系统（CDU）具有多项优势，在胸外科中其应用日益普遍。然而，在心脏手术中，由于其仍偏好使用传统模拟 CDU，因此其应用仍受到限制。为了研究数字 CDU 在心脏手术中的潜在益处，我们比较了我院中心行心脏手术的患者使用这两种系统的安全性和疗效。
我们回顾性分析了 2017 年 6 月至 2017 年 10 月期间在我院行心脏手术的 265 例连续患者。这些患者分为两组：模拟 CDU（A 组，n=65）和数字 CDU（D 组，n=200）。对两组患者的术后结果进行分析和比较。此外，还通过问卷调查评估了“用户体验”。
队列的中位年龄为 70 岁（P=0.167），25.3%的患者为女性（P=0.414）。两组之间在再次手术或使用血液制品方面无差异。收集的总液体量也无差异。然而，在最初的 6 小时内，数字 CDU 收集的液体更多。整体技术故障发生率为 0.4%。我们观察到数字 CDU 管系统中凝结的发生率明显更高（P=0.042）。关于用户体验，数字 CDU 在普通病房的使用更方便（P<0.001）。关于整体用户体验，数字 CDU 优于模拟系统（P=0.002）。
数字 CDU 可安全有效地应用于心脏手术后的患者。由于提高了患者的活动能力和简化了胸腔引流管管理，数字 CDU 的使用可能对心脏手术后的患者有利。但是，应通过进一步的技术改进来解决管系统凝结的问题。
