This large retrospective study found retained blood syndrome (RBS) occurred in 12.7% of cardiac surgery patients and was associated with significantly higher short‑ and long‑term mortality, morbidity, and prolonged ICU and hospital stay. RBS was linked to increased atrial fibrillation, acute kidney injury, and infections. The findings highlight the critical…
Read more »This retrospective cohort study of 476 patients undergoing endoscopic coronary artery bypass grafting (May 2021–January 2025) evaluated the safety of very early postoperative chest drain removal. Despite higher baseline risk in the early‑removal group, these patients experienced significantly shorter drainage duration (5.1 vs. 22.4 hours) and lower total drain output,…
Read more »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.…
Read more »This study compared digital and underwater seal drainage systems in cardiac surgery patients. After matching patients for comparison, those using digital drainage had a significantly lower risk of post-operative atrial fibrillation. However, there were no differences in other outcomes like bleeding, tamponade, pleural effusion, or drain output. The findings suggest…
Read more »This narrative review summarizes evidence supporting posterior pericardiotomy as a simple surgical technique to improve pericardial drainage after cardiac surgery. Studies consistently show reductions in postoperative atrial fibrillation, pericardial effusion, and cardiac tamponade, without an increase in pulmonary complications despite higher rates of pleural effusion. By facilitating postoperative fluid drainage,…
Read more »This retrospective study compared conventional chest drainage, active tube clearance, and portable digital drainage following myocardial revascularization. Both active tube clearance and digital drainage reduced interventions for retained blood syndrome, while portable digital drainage was associated with fewer re-explorations for bleeding and a substantially lower incidence of postoperative atrial fibrillation.…
Read more »This non‑systematic review highlights retained blood syndrome (RBS) as a clinically important complication after cardiac surgery, associated with impaired cardiac and pulmonary function, enhanced inflammation, and worse postoperative outcomes. The authors emphasize that preventing retained blood, pericardial effusions, and pleural effusions should be a priority. From a chest drain management…
Read more »This review introduces the concept of “Drainology” – the science of chest drain management – and highlights the significant variation in postoperative drainage practices across cardiothoracic surgery. Drawing on expert discussions from the AATS Drainology symposium and subsequent research, the authors identify chest drain management as a critical yet under‑standardized…
Read more »This narrative review highlights the central role of chest drains in recovery after cardiac surgery while emphasizing the considerable variation in current management practices. Key decisions (including drain type, number, maintenance of patency, and timing of removal) remain largely guided by tradition rather than robust evidence. The authors identify important…
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