Hydrogel-coated and active clearance chest drains in cardiac surgery: real-world results of a single-center study

Abstract

Purpose Cardiac surgery patients require chest drains for postoperative fluid drainage. Innovations in this field include chemical drain coating and manual clot extraction systems, aiming to provide reduced clotting and improved patient comfort. This study compares outcomes using hydrogel-coated, active clearance and conventional chest drains. Methods Patients with cardiac surgery at our institution from January 2023 to September 2023 were included. Drain allocation was based on surgeon’s choice, with either a combination of hydrogel-coated and conventional, active clearance and conventional, or conventional drains alone. Drain data and clinical outcomes were recorded prospectively. Results One hundred seventy-eight patients (62.9 ± 11.7 years, 67.4% male) received a total of 512 chest drains intraoperatively. Hydrogel-coated and active clearance drains showed higher drainage volumes than conventional drains (p < 0.001, respectively). Patency was lowest in conventional drains (36.7% vs. 98.8% for hydrogel-coated, p < 0.001, and vs. 96.6% for active clearance drains, p < 0.001). Conventional drains showed 5.9 times the odds (95% CI 2.0–25.2) of large pleural effusions compared to hydrogel-coated and 12.0 times the odds (95% CI 1.9–504.1) compared to active clearance drains. Patients with hydrogel-coated drains had the shortest length of stay (p < 0.001). Conclusion Hydrogel-coated and active clearance drains show improved outcomes compared to conventional drains in cardiac surgery.