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Chest tube insertion

Definition

A chest tube insertion involves the surgical placement of a hollow, flexible drainage tube into the chest.

Alternative Names

Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy

Description

Chest tubes are inserted to drain blood, fluid, or air and to allow the lungs to fully expand. The tube is placed between the ribs and into the space between the inner lining and the outer lining of the lung (pleural space).

The area where the tube will be inserted is numbed (local anesthesia). Sometimes sedation (medication to make you relaxed and sleepy) is also used. The chest tube is inserted through an incision between the ribs into the chest and is connected to a bottle or canister that contains sterile water. Suction is attached to the system for drainage. A stitch (suture) and adhesive tape keep the tube in place.

The chest tube usually stays in place until x-rays show that all the blood, fluid, or air has drained from the chest and the lung has fully re-expanded. When the chest tube is no longer needed, it can be easily removed. Most people don't need medications to sedate or numb them while the chest tube is removed. Antibiotics may be used to prevent or treat infection.

In certain people, the chest tube may be inserted using a minimally invasive technique guided by x-ray. Sometimes chest tubes are placed during major lung or heart surgery while the person is under general anesthesia.

Why the Procedure Is Performed

Chest tubes are used to treat conditions that can cause the lung to collapse, such as:

• After surgery or trauma in the chest (pneumothorax or hemothorax)
• Air leaks from the lung into the chest (pneumothorax)
• Bleeding into the chest (hemothorax)
• Lung abscesses or pus in the chest (empyema)

Risks

Risks for any anesthesia are:

• Problems breathing
• Reactions to medications

Risks for any surgery are:

• Bleeding
• Infection

After the Procedure

Most people completely recover from the chest tube insertion and removal. There is only a small scar.

Outlook (Prognosis)

You will stay in the hospital until the chest tube is removed. While the chest tube is in place, the nursing staff will carefully check for possible air leaks, breathing difficulties, and the need for additional oxygen. You'll need to breathe deeply and cough often to help re-expand the lung, assist with drainage, and prevent fluids from collecting in the lungs.