ICU-USA

Tube Thoracostomy

What is a tube thoracostomy?

Critically ill or injured patients may develop a collapsed lung, a large fluid collection around the lung (pleural effusion), an infected fluid collection around the lung (empyema), or a blood collection around the lung (hemothorax). These conditions frequently require a tube thoracostomy, which is the insertion of a chest tube to re-expand the lung and/or remove the fluid or blood around the lung.

What is a chest tube?

A chest tube is a hollow plastic tube that is surgically inserted into the space around the lung and connected to a bedside drainage container. A chest tube is also called a thoracostomy tube.

How is the chest tube used?

A chest tube may be inserted while the patient is in the emergency department, ICU, general hospital room, or the operating room. Patients are usually lying down when a chest tube is inserted. The most common insertion sites are between the ribs on the side or front of the chest. The doctor uses a numbing medicine (local anesthetic) to numb the area through which the chest tube is inserted. A small incision in the skin is made. A narrow track is then made through the chest wall and tube is then inserted into the space around the lung. The chest tube is approximately the size of an adult index finger. The tube is connected to a drainage/collection system attached to the bed. Fluid and air bubbles may be seen entering the collection system.

How long is a chest tube used?

The chest tube remains in place until the lung is re-expanded or the fluid is drained. Occasionally patients require more than one chest tube. Chest X-rays are usually obtained to follow the progress of the chest tube.

Do a tube thoracostomy and chest tube hurt?

Some discomfort may be felt during the insertion procedure. This is usually minimized by use of a numbing medicine (local anesthetic) at the insertion site and pain medicine is given occasionally intravenously. Following insertion, ongoing discomfort is felt by some patients.

Are there any potential complications associated with a tube thoracostomy and a chest tube?

Potential complications of a tube thoracostomy and chest tube include bleeding, inadequate drainage of fluid or blood in the chest, inadequate re-expansion of the lung, improper positioning of the tube, and infections.