Chest Tube Placement

Chest tube placement is a surgical procedure in which a tube is inserted into the chest to act as a drain. The chest tube drains blood, fluid or air from the pleural space, the area between the inner and outer linings of the lung, allowing the lungs to fully expand. It can be performed either as a independent procedure or in conjunction with heart surgery.

Chest tube placement, also called thoracostomy, is used to treat conditions that cause a lung to collapse. These conditions include:

• Surgical complication
• Traumatic injury to the chest
• Pneumothorax, air leakage from the lung into the chest
• Fluid buildup in the chest or pleural effusion
• Hemothorax, an accumulation of blood in the pleural space
• Infection or abscess
• Heart failure
• Emphysema or other disease
• Cancer

Symptoms of lung collapse include the following:

• Sharp chest pain made worse by deep breath or cough
• Shortness of breath
• Chest tightness
• Fatigue after slight exertion
• Rapid heart rate
• Nasal flaring
• Cyanosis, or bluish skin color

It is possible for a small pneumothorax to resolve on its own with rest and the administration of oxygen. It is also possible for a doctor to re-inflate the lung by extracting air from the area around the lung using a needle. In more serious cases, however, a chest tube placement will be necessary. This procedure involves:

General Anesthesia

The patient will be under general anesthesia for the procedure. Before the administration of the general anesthesia, the patient may also be given a sedative to relieve presurgical anxiety.

Placement of a Chest Tube

The chest tube is surgically inserted between the ribs into the space between the inner and outer linings of the lung, known as the pleura, to help drain the air and allow the lung to re-expand. On occasion, the patient may be able to go home with a small chest tube. If a larger chest tube is needed, the patient will be required to stay in the hospital for the duration of this treatment.

Extra Oxygen

In many cases, the patient requires extra oxygen during or after the procedure.

Lung Surgery

In some cases, there may be a need for lung surgery to prevent further episodes of lung collapse. Sometimes, a special chemical will be surgically placed on the weakened in order to cause a scar to form as a patch. This procedure is called pleurodesis.

While they rarely occur, there are possible risks associated with the placement of a chest tube. These may include:

• Recurrence of lung collapse
• Shock
• Adverse reactions to anesthesia or medications
• Post-surgical infection
• Damage to adjacent organs
• Damage to the lung which may result in breathing problems

After a chest tube placement, patients usually remain in the hospital until the lungs have properly drained and the chest tube has been removed. The patient will have to cough and breathe deeply to help the lung re-expand. Antibiotics may be prescribed during recovery to prevent infections. Once the patient has fully recovered, steps will be taking to avoid a recurrence of the problem. Only a small scar will result from this procedure.