The purpose of this prospective, randomized controlled clinical trial is to evaluate early postoperative outcomes and fluid drainage dynamics between continuous active negative-pressure chest drainage (-10 mmHg) and standard spontaneous closed underwater-seal drainage in adult patients undergoing elective isolated coronary artery bypass grafting (CABG).
Postoperative pericardial and pleural fluid accumulation following cardiac surgery can lead to complications such as postoperative atrial fibrillation (POAF), cardiac tamponade, or symptomatic pleural effusion. While low-intensity negative-pressure suction is commonly used in general thoracic procedures, its routine application in cardiac surgery remains debated.This prospective randomized study evaluates whether maintaining continuous low-intensity active negative-pressure chest drainage (-10mmHg) during the first 48 hours postoperatively improves early fluid evacuation and reduces early morbidity compared with conventional spontaneous closed underwater-seal chest drainage.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
400
Continuous low-intensity active negative-pressure suction (-10mmHg) applied to chest drains via central vacuum wall suction for the first 48 hours postoperatively following coronary artery bypass grafting (CABG).
Başakşehir Çam Ve Sakura Şehir Hastanesi
Istanbul, Istanbul, Turkey (Türkiye)
Pre-discharge echocardiographic assessment
Pericardial effusion volume and left ventricular ejection fraction (LVEF) measured in percentage (%) via transthoracic echocardiography prior to hospital discharge.
Time frame: 7-14 days after the surgery
Cumulative drainage volume at 24 and 48 hours
Total volume of thoracic drainage fluid measured in milliliters (mL) at 24 and 48 hours postoperatively.
Time frame: First 24 and 48 hours after the surgery
Incidence of postoperative complications
Rate of early complications occurring within 48 hours postoperatively, including postoperative atrial fibrillation (POAF), pneumothorax, and symptomatic pleural effusion requiring intervention. Composite rate of major complications within 30 days postoperatively, including surgical re-exploration for bleeding or cardiac tamponade, requirement for extracorporeal membrane oxygenation (ECMO) support, deep sternal wound infection or sternal revision, and 30-day all-cause mortality.
Time frame: It will be evaluated during the patient follow-ups at the first 48 hours and the one-month check-ups.
Postoperative recovery metrics
Intensive care unit (ICU) length of stay and total hospital length of stay measured in days
Time frame: from surgery to discharge (5-30 days)
Duration of intubation
the time elapsed from the point of intubation at the start of the operation until extubation
Time frame: 10-360 hours
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.