The Impact Of Active Chest Tube Clearance Technology On Surgical Outcomes After Cardiac Surgery: An Updated Systematic Review And Meta-Analysis


  • Basil Ahmad Queen’s University School of Medicine, Kingston, ON, Canada
  • Vithusha Yogathasan Queen’s University School of Medicine, Kingston, ON, Canada
  • Eric Meng Queen’s University School of Medicine, Kingston, ON, Canada
  • William Khoury Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
  • Ali M. Alakhtar Division of Cardiac Surgery, Department of Surgery, McGill University, Montreal, QC, Canada; Department of Surgery, Qassim University, Qassim, Kingdom of Saudi Arabia
  • Angel-Luis Fernandez Cardiac Surgery Department, University Hospital, Santiago de Compostela, Spain
  • Mohammad El-Diasty Harrington Heart and Vascular Institute, Cardiac Surgery Department, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA



Cardiac Surgery, Active Clearance Technology, Mediastinal drains, Chest drains, Re-exploration, Postoperative bleeding


Objective: Active chest tube clearance technology (ACT) systems were introduced to improve the patency of chest tubes and to reduce the potential complications associated with inadequate mediastinal blood drainage after cardiac surgical procedures. The purpose of this study is to assess the impact of ACT on the incidence of chest tube clogging, retained blood syndromes (RBS), re-exploration for bleeding, and the incidence of postoperative atrial fibrillation (POAF) after cardiac surgical procedures.
Methods: A database search was conducted using Medline, Embase, Cochrane Library, and Web of Science. Only articles comparing the use of ACT to conventional chest tube drainage after cardiac surgery were screened. Included articles were restricted to adult patients and English language only.
Results: Nine of the 841 articles screened were included in this review. Two studies were randomized controlled trials (RCT) and seven were observational studies. Pooled estimates showed RBS, surgical re-exploration rates, and POAF were significantly less common in the ACT group.
Conclusion: Our meta-analysis suggests that the use of ACT may be beneficial in reducing the incidence of postoperative complications associated with inadequate drainage of mediastinal blood after cardiac surgery. However, more robust evidence is required to endorse these findings and support the routing use of ACT in clinical practice.


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How to Cite

Ahmad B, Yogathasan V, Meng E, Khoury W, M. Alakhtar A, Fernandez A-L, El-Diasty M. The Impact Of Active Chest Tube Clearance Technology On Surgical Outcomes After Cardiac Surgery: An Updated Systematic Review And Meta-Analysis. Rev Port Cir Cardiotorac Vasc [Internet]. 2023 Oct. 11 [cited 2024 May 22];30(3):43-5. Available from:



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