Chest Tube Thoracostomy

Chest Tube Thoracostomy

Chest tube thoracostomy involves placing a hollow plastic tube between the ribs and into the chest to drain fluid or air from around the lungs. The tube is often hooked up to a suction machine to help with drainage. The tube remains in the chest until all or most of the air or fluid has drained out, usually within a few days. The procedure is ideally done by a pulmonologist.

Why Do I Need a Chest Tube?

Common reasons why a chest tube is needed include:

• Collapsed lung (pneumothorax) – This occurs when air has built up in the area around the lungs (the pleural space) from a leak in the lung. This leak may be the result of lung disease. It can also occur as a complication of certain medical procedures, Trauma. Chest tubes are often needed to remove air from around the lung. Failure to remove such air can be life-threatening if there is a lot of air or a continued leak. Removing the air allows the lung to re-expand and seal the leak.
• Pleural effusion – An infection can sometimes cause fluid to build up around the lung and may be necessary to insert a chest tube to remove the fluid. Getting the fluid out can at times help clear the infection faster. A culture can also be done on the fluid to try to figure out what type of infection is present. Dr. Abhijeet Singh does the procedure expertly as he is a pleural effusion specialist in Greater Noida.
• Cancer – Some cancers spread to the lung or pleura (lining of the lung). This can cause large amounts of fluid to build up around the lung. Doctors usually drain the fluid with a needle. If the fluid keeps coming back, however, it may be necessary to insert a chest tube to first drain the fluid, and then deliver special medicines into the chest that reduce the likelihood of the fluid building up again.
• Chest Surgery – Sometimes a chest tube is left in place after surgery. The surgeon can usually tell you if it will be needed and how long it may need to stay in.

Risks of Chest Tube Insertion:

Below are listed some risks of chest tube thoracostomy. It should be noted that the risk of serious complications (bleeding and infection) is uncommon (usually less than 5% of cases). Your healthcare provider will explain the risks and how likely they may be for you when you give consent for the procedure.

• Pain during placement: Discomfort often occurs as the chest tube is inserted. Local numbing medicine is used to help reduce any pain or discomfort. The discomfort usually decreases once the tube is in place.
• Bleeding: A blood vessel in the skin or chest wall may be nicked as the tube is being placed. Bleeding is usually minor and stops on its own. Rarely, bleeding can occur in or around the lung and may require surgery. Usually, bleeding can just be watched with the chest tube in place.
• Infection: Bacteria can enter around the tube and cause an infection around the lung. The longer the chest tube stays in the chest, the greater the risk for infection. The risk of infection is decreased by special care in bandaging the skin at the point where the tube goes into the chest.
• Leak of Air into skin: It occurs due to leaking of air from pleural space into the skin and subcutaneous tissue.

Chest tube insertion

Fluid or air in the chest that needs to be drained is identified using chest imaging such as chest X-ray, chest ultrasound, or chest CT scan. If the X-ray shows a need for a chest tube thoracostomy to drain fluid or air, the procedure is likely to be done by a surgeon, a pulmonary/critical care physician.

Often an adult or older child remains awake when a chest tube is inserted, except when it is placed in the operating room during an open chest procedure. The chest tube will be connected to a drainage collection device (usually a clear plastic container that rests on the floor). Often it is attached to suction to help draw out the air or fluid. Get treatment for pleural effusion by Dr. Abhijeet Singh - Pleural effusion specialist in Greater Noida.

Will there be any pain or possible complications when the chest tube is removed?

Generally, there are no complications from the chest tube once it has been removed. You will only have a small scar. Chest tube insertion is a relatively safe procedure when done by Pulmonologist