UNASSIGNED: Prospective non-blinded cluster-randomized study with alternating chest tube removal protocol in adult patients undergoing elective cardiac surgery. Monthly changing allocation to scheduled chest tube removal on the day of surgery (Day 0) versus removal on the 1st postoperative day (Day 1) provided no air leakage and output < 200 mL within the last four hours.
UNASSIGNED: A total of 527 patients were included in the study from September 1st 2020 until October 29th 2021 and randomly allocated to chest tube removal at day 0 (n = 255), and day 1 (n = 272). More than every fourth patient required drainage for pleural effusion with no significant difference between the groups. Earlier removal of chest tubes did not reduce requirement of analgesics, improve early respiratory function, or reduce postoperative complications. The study was halted for futility after halfway interim analysis showed insufficient promise of any treatment benefit.
UNASSIGNED: Fast-track protocols with chest tube removal within the first 24 h after cardiac surgery may be associated a high rate of pleural effusions.
■在接受择期心脏手术的成年患者中,采用交替的胸管摘除方案的前瞻性非盲整群随机研究。在手术当天(第0天)与在术后第1天(第1天)移除胸管相比,每月改变分配给计划的胸管移除,在过去4小时内没有漏气且输出<200mL。
■从2020年9月1日至2021年10月29日,共有527名患者被纳入研究,并在第0天随机分配到胸管摘除术(n=255)。和第1天(n=272)。超过四分之一的患者需要引流胸腔积液,两组之间没有显着差异。早期取出胸管并没有减少镇痛药的需求,改善早期呼吸功能,或减少术后并发症。中途中期分析显示任何治疗益处的承诺不足后,该研究因无效而停止。
■在心脏手术后的最初24小时内进行胸管拔除的快速通道方案可能与高胸腔积液率相关。