Chest tube insertion
| Normal anatomy |
|
The pleural space is the space between the inner and outer
lining of the lung. It is normally very thin and lined only with a
very small amount of fluid.
|
| Indication |
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If air or fluid, such as blood, gets into the pleural space, the
lung can collapse, preventing adequate air exchange. 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)
- Pus in the chest (empyema)
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| Procedure |
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Chest tubes are inserted to drain blood, fluid, or air and allow
full expansion of the lungs. The tube is placed in the pleural
space. The area where the tube will be inserted is numbed with
local anesthesia. The patient may also be sedated. The chest tube
is inserted 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. Antibiotics may be
prescribed to prevent or treat infection.
|
| Aftercare |
|
Recovery from the chest tube insertion and removal is usually
complete, with only a small scar.
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.
|
Review Date: 5/12/2009
Reviewed By: James Lee, MD, Department of Surgery, Columbia
Presbyterian Medical Center, New York, NY. Review provided by
VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA,
Medical Director, A.D.A.M., Inc.
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