Barozzi Luca, Biagio Livio San, Meneguzzi Matteo, Courvoisier Delphine S, Walpoth Beat H, Faggian Giuseppe
Division of Cardiac Surgery, University of Verona, Verona, Italy.
Quality of Care Unit, University Hospital, Geneva, Switzerland.
J Card Surg. 2020 Jul;35(7):1492-1497. doi: 10.1111/jocs.14629. Epub 2020 May 21.
A new, self-contained, digital, continuous pump-driven chest drainage system is compared in a randomized control trial to a traditional wall-suction system in cardiac surgery.
One hundred and twenty adult elective cardiac patients undergoing coronary artery bypass graft and/or valve surgery were randomized to the study or control group. Both groups had similar pre/intra-operative demographics: age 67.8 vs 67.0 years, Euroscore 2.3 vs 2.2, and body surface area 1.92 vs 1.91 m . Additionally, a satisfaction assessment score (0-10) was performed by 52 staff members.
Given homogenous intra-operative variables, total chest-tube drainage was comparable among groups (566 vs 640 mL; ns), but the study group showed more efficient fluid collection during the early postoperative phase due to continuous suction (P = .01). Blood, cell saver transfusions and postoperative hemoglobin values were similar in both groups. The study group experienced drain removal after 29.8 vs 38.4 hours in the control group (ns). Seven crossovers from the Study to the Control group were registered but no patient had drain-related complications. The Personnel Satisfaction Assessment scored above 5 for all questions asked.
The new, digital, chest drainage system showed better early drainage of the chest cavity and was as reliable as conventional systems. Quicker drain removal might impact on intensive care unit (ICU) stay and reduce costs. Additional advantages are portable size, battery operation, patient mobility, noiseless function, digital indications and alarms. The satisfaction assessment of the new system by the staff revealed a higher score when compared to the traditional wall suction chest drainage system.
在一项随机对照试验中，将一种新型的、独立的、数字式、连续泵驱动的胸腔引流系统与心脏手术中的传统壁式吸引系统进行比较。
120例接受冠状动脉搭桥和/或瓣膜手术的成年择期心脏患者被随机分为研究组或对照组。两组患者术前/术中的人口统计学特征相似：年龄分别为67.8岁和67.0岁，欧洲心脏手术风险评估系统（Euroscore）评分分别为2.3和2.2，体表面积分别为1.92平方米和1.91平方米。此外，52名工作人员进行了满意度评估评分（0 - 10分）。
考虑到术中变量相同，两组的胸腔引流总量相当（566 vs 640 mL；无统计学差异），但由于持续吸引，研究组在术后早期的液体收集效率更高（P = 0.01）。两组的血液、细胞回收输血和术后血红蛋白值相似。研究组在术后29.8小时拔管，而对照组为38.4小时（无统计学差异）。记录到7例从研究组转至对照组的交叉情况，但没有患者出现与引流相关的并发症。所有问题的人员满意度评估得分均高于5分。
新型数字式胸腔引流系统显示出更好的胸腔早期引流效果，并且与传统系统一样可靠。更快的拔管可能会影响重症监护病房（ICU）的住院时间并降低成本。其他优点包括便携式尺寸、电池供电、患者可移动、无噪音功能、数字显示和警报。工作人员对新系统的满意度评估显示，与传统壁式吸引胸腔引流系统相比，得分更高。
