Chest-tube placement (thoracostomy) is a surgical procedure in which a tube is inserted into the chest to act as a drain. The tube drains blood, fluid or air from the pleural space (the area between the inner and outer linings of the lung), enabling the lungs to fully expand. It can be performed as an independent procedure or in conjunction with heart surgery.
Reasons for Chest-Tube Placement
Chest-tube placement is used to treat problems or conditions, including the following, that cause lung collapse:
- Surgical complication
- Traumatic injury to the chest
- Pneumothorax (air leakage from the lung into the chest)
- Fluid buildup in the chest (pleural effusion)
- Hemothorax (accumulation of blood in the pleural space)
- Heart failure
- Emphysema or other disease
Treating infections or abscesses can also require chest-tube placement.
Symptoms of Lung Collapse
Symptoms of lung collapse that may or may not necessitate chest-tube placement 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, in which the skin takes on a bluish hue, is also a symptom of lung collapse.
Placement of a Chest Tube
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 reinflate the lung by using a needle to extract air from the area around it. In more serious cases, however, chest-tube placement, which includes some or all of the steps below, is necessary.
The patient is given general anesthesia for the procedure. Before its administration, the patient may be given a sedative to relieve presurgical anxiety.
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 air and allow the lung to reexpand. On occasion, the patient is able to go home with a small chest tube. If a larger chest tube is needed, the patient is required to stay in the hospital for the duration of treatment.
In many cases, the patient requires extra oxygen during or after the procedure.
In some cases, there may be a need for lung surgery to prevent further episodes of lung collapse. Sometimes, a special chemical is surgically inserted into the space between the lung's inner and outer linings, causing inflammation that fuses them together. This procedure is called "pleurodesis."
The incision made between the ribs to insert the chest tube is about an inch long.
Complications of Chest-Tube Placement
Although they rarely occur, there are possible risks, including the following, associated with the placement of a chest tube:
- Recurrence of lung collapse
- Adverse reactions to anesthesia or medications
- Post-surgical infection
- Damage to the lung that can cause breathing problems
Damage to adjacent organs is also a possible complication of chest-tube placement.
Recovery From Chest-Tube Placement
After chest-tube placement, a patient usually remains in the hospital until the lungs have properly drained, and the chest tube has been removed. The patient must cough and breathe deeply to help the lung reexpand. Antibiotics may be prescribed during recovery to prevent infections. Chest-tube placement leaves only a small scar.
- National Institutes of Health
- Centers for Disease Control and Prevention
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- U.S. Department of Health & Human Services
- U.S. National Library of Medicine
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