A chest tube is a hollow plastic tube which is inserted into the chest cavity to drain air or fluid. Fluid in the chest may be blood (such as following surgery or trauma), or pus (from an infection such as pneumonia).
When are they Used?
A chest tube may be inserted for several reasons:
- To reexpand the lungs when a lung collapses (pneumothorax). With a pneumothorax, the tube is inserted into the pleural cavity - the space between the membranes (pleura) that line the lungs
- After surgery for lung cancer to drain fluids that remain in the space created after a portion of a lung is removed
- After heart surgery
- If there is bleeding into the chest (hemothorax), for example, from trauma
- To drain pus from an infection or abscess (empyema)
When a chest tube is inserted for a collapsed lung, a small area on the chest is numbed by using a local anesthetic. The tube is then inserted, and connected to a machine which uses suction to remove the air, thus allowing the lung to reexpand. The tube is sutured in place so it won’t pull out with movement.
When a chest tube is inserted following surgery, it is placed under general anesthesia in the operating room. The tube is then connected to a container lower than the chest, using gravity to allow the excess fluids to drain.
How Long are They Left in Place?
The amount of time a chest tube will remain in place can vary depending upon the reason it is placed, and how long an air leak or fluid drainage continues. With a pneumothorax, doctors will look at an x-ray to make sure all of the air has been removed, and the lung has expanded completely. Following lung cancer surgery, the tube will be left in place until only minimal drainage remains, often a period of 3 to 4 days.
Removal of a chest tube is usually a fairly easy procedure, and can be done comfortably in your hospital bed without any anesthesia. The sutures are separated and the tube is then clamped. Your doctor will ask you to take a breath and hold it, and the tube is pulled out. The suture is then tied to close the wound and a dressing applied. If the tube was placed for a collapsed lung, an x-ray will be done to make sure the lung remains expanded after removal.
National Institute of Health. Medline Plus. Chest tube insertion. Updated 03/03/12. http://www.nlm.nih.gov/medlineplus/ency/article/002947.htm