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 you will be given medication to make you relaxed and sleepy (sedation) through a vein (intravenously).

The chest tube is inserted through a one-inch cut in the skin between the ribs into the chest. It 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. After every chest tube insertion, a chest x-ray is done to make sure it is in the right 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 or ultrasound. Chest tubes are usually 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)
• Collection of fat in the chest (chylothorax)
• Lung abscesses or pus in the chest (empyema)

Risks

Risks from any anesthesia are:

• Problems breathing
• Reactions to medications

Risks from any surgery are:

• Bleeding
• Infection

Risks from the procedure itself:

• Accidental movement of the tube
• Buildup of pus (empyema)
• Improper placement of the tube--into the tissues, abdomen, or too far in the chest
• Injury to the lung or heart
• Injury to the spleen, liver, stomach, or diaphragm

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 oxygen. You'll need to breathe deeply and cough often to help re-expand the lung, help with drainage, and prevent fluids from collecting in the lungs.

Chest x-rays are done often while a chest tube is in place to make sure that all of the air, blood, and other fluids are being removed.

Alternative Names

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

Update Date: 5/10/2012

Reviewed by: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.