More information about chest tube placement or tube thoracostomy
Chest tube placement is a medical procedure which a physician or advanced practice provider may choose to perform for a variety of reasons. One common use for chest tube placement (or tube thoracostomy) is in cases where a patient has a collapsed lung. In this case, a physician inserts a chest tube between the patient’s ribs until it is in the pleural space adjacent to the collapsed lung. Suction is then applied to the chest tube so that the air in the pleural space can be sucked out allowing the collapsed lung to re-expand. You can learn more about the process for treating breathing issues by visiting our Needle Decompression Course page and our Tube Thoracostomy Course page.
Another application for chest tube placement that many patients and medical students may be unaware of is its use after heart or lung surgery. After both open heart surgery and lung resection surgery, chest tubes are routinely left in place to drain any residual fluid that collects in the space around the left lung.
Finally, chest tube placement, or tube thoracostomy, can be utilized to perform a chemical pleurodesis usually in the setting of cancer-related pleural effusions. During this procedure, a chest tube first drains all of the fluid that has collected in the pleural space. Then, one of several agents (talc, bleomycin, or tetracycline) can be placed through the chest tube into the pleural space causing an inflammatory process that seals up this potential space ideally preventing further fluid to re-accumulate.
Chest tube placement frequently causes anxiety or fear in patients and can be quite painful without adequate pre-medication. Psychologically, patients can feel very vulnerable at the thought of an invasive procedure in the chest and side area. Unfortunately, in some cases patients have reported experiencing significant pain during a chest tube procedure. For this reason, we strongly advocate the use of moderate-to-deep procedural sedation for all non-emergent chest tube insertions.
The potential complications arising from a chest tube procedure include infection, bleeding, or the misplacement of the tube. More severe complications are reported in fewer than 5 out of every 100 chest tube placement procedures. There is no great reason for patients to be concerned though as the risk of infection is quite low due to efforts to maintain maximum sterility. In addition, the chance of serious bleeding or injury to internal organs is minimal.
If you’re working in a segment of the medical industry which doesn’t require you to actively perform or assist in chest tube placement, it is still valuable to understand the procedure so that you can provide an informed explanation to your patients or co-workers if called upon.
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