Effectiveness of Active Chest Tube Clearance Versus Conventional Chest Tube in Reducing Postoperative Complications After Cardiac Surgery: a Systematic Review and Meta-analysis

SN Comprehensive Clinical Medicine - Tập 4 - Trang 1-12 - 2022
Mohammed Tarek Hasan1,2, Abdulrahman Ibrahim Hagrass1,2,3, Mohamed Nabil Elkhrashy1,2, Mohamed Hamouda1,2, Noura Mohamed shada2,4, Sarah M. Hashem2,4, Mohammed Al-kafarna2,5, Hossam Waleed Almadhoon2,6, Khaled Mohamed Ragab2,7, Anas Zakarya Nourelden1,2, Ahmed Bostamy Elsnhory1,2
1Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
2International Medical Research Association (IMedRA), Cairo, Egypt
3New Cairo, Egypt
4Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
5Faculty of Pharmacy, Al-Azhar University, Gaza, Palestine
6Faculty of Dentistry, Al-Azhar University, Gaza, Palestine
7Faculty of Medicine, Minia University, Minia, Egypt

Tóm tắt

After heart surgery, the chest tube removes lost mediastinal blood. Clogging of the chest tube may induce inadequate evacuation of fluids surrounding the lungs and heart, leading to deadly consequences. This meta-analysis compared the effectiveness of active chest tube clearance (ATC) with conventional chest tube (CT) in lowering the incidence of retained blood complications after heart surgery. We conducted a systematic search of the available databases to identify cohort studies or clinical trials that met our inclusion criteria. Studies that compared active tube clearance and conventional tube in cardiac surgery were included. The fixed or random-effects model was used to determine the pooled effect estimates upon the heterogeneity of collected data. This review included 7003 people from five cohort studies and three clinical trials. As regard to retained blood, there was no significant difference between chest tube types in matched group (RR = 0.67, 95% CI = [0.44, 1.04], P = 0.08) or unmatched group (RR = 0.64, 95% CI = [0.39, 1.04], P = 0.07). Re-exploration favored ATC in the matched group (RR = 0.64, 95% CI = [0.43, 0.95], P = 0.03). The incidence of postoperative atrial fibrillation was significantly lower in ATC in both matched (RR = 0.73, 95% CI = [0.61, 0.87], P = 0.0005) and unmatched groups (RR = 0.72, 95% CI = [0.61, 0.84], P = 0.0005). This meta-analysis provides evidence on the positive effect of active maintenance of chest tube patency during the first hours of cardiac surgery, which resulted in reducing the incidence of complications.

Tài liệu tham khảo

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