Edward Hauptmann, Erin Hoover, Raghav Chandra, Madhuri Nagaraj, Paige Deblieux, Jasmina Ehab, Suresh Keshavamurthy  |  March 26, 2026

This narrative review examines posterior pericardiotomy as a simple intraoperative strategy to improve pericardial drainage after cardiac surgery. Evidence shows that posterior pericardiotomy reduces postoperative pericardial effusion, cardiac tamponade, and atrial fibrillation by facilitating fluid egress and limiting pericardial inflammation. Despite guideline support, the technique remains underutilized. Wider adoption may…

Lars Geenen, Koen C. H. A. Verkoulen, Iris E. W. G. Laven, Jean H.T. Daemen, Lori M. van Roozendaal, Chiel J. Franssen, Aimée J. P. M. Franssen, Juliette H.R.J. Degens, Karel W. E. Hulsewé, Yvonne L. J. Vissers, Joel Dunning, Alessandro Brunelli, and Erik R. de Loos  |  March 16, 2026

This systematic review and network meta‑analysis evaluated chest drain management strategies after anatomical lung resection. Among eight approaches, digital drainage – particularly with alternating suction- – was associated with shorter drainage duration and length of hospital stay compared with analogue systems. Continuous suction appeared less effective than water seal or…

Muralie Vignarajah, Lucas Ilic, Anood Alqaydi, Bram Rochwerg, Andrew Gil  |  February 28, 2026

This systematic review evaluated the clinical value of routine chest X‑rays after chest tube removal versus imaging guided by clinical assessment. Across largely non‑randomized studies, omitting routine post‑pull X‑rays showed no clear impact on hospital length of stay or chest tube duration, though evidence certainty was very low. The findings…

Marc W. Gerdisch  |  March 8, 2026

The Fast Forward to Full Function (F4) framework was developed to promote rapid, reliable functional recovery and mobility for cardiac surgery patients across all risk categories. As postoperative immobility remains a major contributor to complications and reduced patient satisfaction, F4 addresses a critical need—especially as less invasive transcatheter options become…

Riya Aggarwal, Jeremiah Hutson, David Zapata, Howard Massey, Bradley Taylor, Bartley Griffith and Justin Robinson  |  February 3, 2026

This review explores emerging ERAS strategies in cardiothoracic transplantation, highlighting chest drain management as a key driver of recovery. Evidence supports early chest tube removal—ideally by postoperative day one—to facilitate respiratory rehabilitation, reduce pulmonary complications, and enable early mobilization. Integrated with opioid‑sparing analgesia and structured physiotherapy, optimized chest drain protocols…

Chit Wong, Joshua Wright, Francesco Luke Siena, Philip Breedon, David W. Hewson, and Martin Beed  |  May 29, 2026

This scoping review screened 5,275 records and included 63 studies, identifying nine chest drain fixation principles, often used in combination. Although no definitive method emerged, trends suggest that suture-based or combined techniques (eg, sutures with dressings, cable ties, or balloon catheters) may improve security. Link to publication

Mohamed Saad Rakab, Ameer Awashra, Nada Radwan, Abdalhakim Shubietah, Alaa Maamoun, Mohab Mattar, AlMothana Manasrah, Abdelrahman Ghanem, Abdelrahman Elbaz, Ali Emara & Hamza A. Abdul-Hafez  |  December 16, 2025

This meta‑analysis evaluated early versus late chest tube removal after cardiac surgery. Early removal shortened hospital stay without affecting mortality, infection, atrial fibrillation, or ICU length of stay. However, it was associated with a higher risk of pericardial effusion and a trend toward increased pleural effusion. These findings support early…

Stefano Granieri, Stefano Piero Bernardo Cioffi, Alessandro Asaro, Michele Altomare, Andrea Spota, Francesco Virdis, Roberto Bini, Shailvi Gupta, Kimberly Davis & Stefania Cimbanassi  |  November 27, 2025

This systematic review and meta-analysis of randomized trials compared small‑bore versus large‑bore chest tubes in adult trauma patients. Small‑bore tubes demonstrated similar failure and complication rates, with a modest but significant reduction in drainage duration. No differences in hospital stay were observed. However, trial sequential analysis showed the current evidence…

Irene Bello, Laurens J. Ceulemans and Cristiano Amarelli  |  November 5, 2025

This narrative review highlights the role of ERAS in cardiothoracic transplantation, emphasizing standardized chest drain management as a key enabler of recovery. Evidence supports early chest tube removal, avoidance of routine suction, and use of digital drainage systems to objectively monitor air leaks and output, facilitating early mobilization and reduced…

Janet Simsic, Virginia Kathleen Cox, Brittany Shutes, Jennifer Gauntt, Aymen Naguib, Mark Galantowicz, Patrick McConnell  |  October 30, 2025

This retrospective institutional review evaluated routine mediastinal chest drain removal on postoperative day 1 after cardiopulmonary bypass surgery. Among 158 patients, chest drains were typically removed at ~22 hours with minimal output. Early drain removal was associated with low rates of clinically significant pericardial effusion and rare need for reintervention.…