Fig. 3

Graphical abstract. Chest tube clogging is common and can lead to retained blood around the heart and lungs. This study sought to evaluate the impact of a chest drainage protocol aimed at actively maintaining chest tube patency after cardiac surgery. Patients undergoing non-emergent cardiac surgery through median sternotomy were randomly allocated according to a 1:1 ratio to either ATC or standard drainage protocol. ATC was associated with non-significant reduction in POAF, lowered need for re-exploration for bleeding or tamponade and improved chest tube patency. This randomized controlled trial demonstrated that maintaining chest tube patency is paramount after cardiac surgery and may improve patient outcomes. ATC, active tube clearance; POAF, postoperative atrial fibrillation