Insertion of tube into chest

Alternative names
Chest drainage tube insertion; Chest tube insertion; Tube thoracostomy

Definition
Surgical insertion of a hollow, flexible drainage tube into the chest.

Description
Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. 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). The patient may also be sedated. 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 to encourage drainage. A stitch (suture) and adhesive tape is used to keep the tube in place.

The chest tube usually remains in place until the 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, usually without the need for medications to sedate or numb the patient. Medications may be used to prevent or treat infection (antibiotics).

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

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

Risks
Risks for any anesthesia are:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery are:

     
  • Bleeding  
  • Infection

Expectations after surgery
Recovery from the chest tube insertion and removal is usually complete, with only a small scar.

Convalescence
The patient 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 need for additional oxygen. Frequent deep breathing and coughing is necessary to help re-expand the lung, assist with drainage, and prevent normal fluids from collecting in the lungs.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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