自动清线胸管减少心脏手术后的疼痛和房颤。

JTCVS open Pub Date : 2024-09-24 eCollection Date: 2024-12-01 DOI:10.1016/j.xjon.2024.09.019
Elbert E Heng, Oluwatomisin Obafemi, Danielle Mullis, Alyssa Garrison, Hanjay Wang, Jack H Boyd
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引用次数: 0

摘要

目的:胸管技术的最新进展引起了人们的兴趣,因为它们能够通过减少心胸外科手术后潴留血综合征来增强术后恢复。本研究探讨了Centese Thoraguard自动清线胸管系统对心脏手术后疼痛和恢复的影响。方法:这是一项单中心回顾性研究,纳入了2021年1月至2022年12月期间接受非紧急心脏手术的1771名成年患者。我们分析了184例采用Thoraguard自动清除胸管和1587例常规胸管的围手术期数据。在133对具有相似术前特征的患者的倾向匹配队列中比较术后结果。结果:与常规胸管相比,采用自动清除胸管的心脏手术患者在术后第三天(5比6,P = 0.02)和出院时(0比3,P = 0.04)疼痛评分(0-10)显著降低。在接受自动清除胸管的患者中,自动清除胸管与更短的呼吸机使用时间相关(5.3小时vs 5.8小时,P P = 0.02)。在死亡率、心肌梗死或卒中方面,自动清线和常规胸管没有显著差异。结论:在常规心脏手术中使用Thoraguard自动清线胸管系统可改善术后疼痛控制,缩短呼吸机使用时间,减少术后心房颤动,而不增加发病率或死亡率。
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Automated line-clearing chest tubes reduce postoperative pain and atrial fibrillation after cardiac surgery.

Objective: Recent advancements in chest tube technologies have gained interest for their ability to enhance postoperative recovery via reduction of retained blood syndrome after cardiothoracic surgery. The present study investigates the effect of the Centese Thoraguard automated line-clearance chest tube system on postoperative pain and recovery after cardiac surgery.

Methods: This was a single-center retrospective review of 1771 adult patients undergoing nonemergency cardiac surgery between January 2021 and December 2022. Perioperative data were analyzed in 184 patients undergoing surgery with Thoraguard automated clearance chest tubes and 1587 patients with conventional chest tubes. Postoperative outcomes were compared in a propensity-matched cohort of 133 patient pairs with similar preoperative characteristics.

Results: Patients undergoing cardiac surgery with automated clearance chest tubes demonstrated significant reductions in pain scores (0-10) compared with conventional chest tubes on the third postoperative day (5 vs 6, P = .02) and at hospital discharge (0 vs 3, P = .04). Automated clearance chest tubes were associated with a shorter time on the ventilator (5.3 vs 5.8 hours, P < .001). There was a significant reduction in postoperative atrial fibrillation (18.1% vs 30.8%, P = .02) in patients receiving automated clearance chest tubes. There were no significant differences in mortality, myocardial infarction, or stroke between automated line-clearing and conventional chest tubes.

Conclusions: The use of the Thoraguard automated line-clearing chest tube system in routine cardiac surgery was associated with improved postoperative pain control, decreased ventilator duration, and decreased postoperative atrial fibrillation without increased morbidity or mortality.

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