PleuraFlow Active Clearance Technology for maintaining chest tube patency

The technology described in this briefing is PleuraFlow Active Clearance Technology (ACT). It is a chest drain that incorporates a tube clearance system.

The innovative aspects are that it is designed to prevent the formation of blood clots within chest tubes and, if they do occur, to actively remove them.

The intended place in therapy would be to replace standard chest drains in people who need them, such as those who have had cardiothoracic surgery or surgery after trauma.

The main points from the evidence summarised in this briefing are from 4 studies involving a total of 827 adults. They suggest that PleuraFlow ACT may be more effective than conventional chest tubes for reducing complications in people having cardiac surgery.

Key uncertainties around the evidence base, which is still developing, are the variety of outcome measures used and the lack of randomised studies to compare PleuraFlow ACT with standard chest drains. There are also no published reports from the UK, so it is unclear if the results are generalisable to the NHS.

The cost of PleuraFlow ACT is £295 per unit (exclusive of VAT). The resource impact is likely to be greater than standard chest drains, which cost around £6, because PleuraFlow ACT costs more. These costs may be offset if using PleuraFlow ACT reduces complications and subsequent NHS resource use.