A chest tube is a flexible, hollow tube inserted into the chest cavity to remove accumulated air, fluid, or blood. This procedure helps to restore normal pressure within the pleural space, which is the area between the lungs and the chest wall. By draining these substances, a chest tube allows the compressed lung to re-expand, facilitating improved breathing and lung function. The tube is connected to a closed drainage system that prevents air or fluid from re-entering the chest, maintaining a one-way flow out of the body.
Continuous Versus Intermittent Suction
Chest tube drainage systems can utilize either continuous or intermittent suction to aid in removing air or fluid from the pleural space. Continuous suction involves applying a steady, uninterrupted negative pressure to the drainage system. This constant pressure helps to actively pull substances out of the chest cavity. In a wet suction system, continuous suction is typically visible as gentle, consistent bubbling in the suction control chamber, confirming the system is actively engaged. Dry suction systems achieve this constant negative pressure through a self-regulating mechanism, often indicated by a visual display or bellows.
Intermittent suction, by contrast, applies negative pressure in cycles, turning on and off periodically. This method is less frequently employed in current medical practice compared to continuous suction. When intermittent suction is used, the bubbling in the suction control chamber would appear to start and stop, reflecting the cycling of the applied pressure. It is important to differentiate this from intermittent bubbling in the water-seal chamber, which typically indicates an air leak from the patient’s lung.
When Each Suction Type is Used
Continuous suction is commonly applied in various clinical scenarios to effectively manage the pleural space. It is often used for persistent air leaks from the lung, where a steady negative pressure helps to evacuate air and promote lung re-expansion. Following chest surgeries, continuous suction can facilitate the rapid drainage of significant fluid or blood, preventing accumulation that could hinder lung function. The consistent pull helps to maintain lung inflation and efficiently remove any accumulating substances. Typical continuous suction pressures range from -10 to -20 cm H2O, though this can be adjusted based on the patient’s specific needs.
Intermittent suction is reserved for very specific and less common situations. It might be considered during a trial period to assess if an air leak has resolved before the chest tube is removed. In such cases, the suction may be temporarily disconnected or cycled off to observe if the lung remains expanded without the constant support. This approach helps healthcare professionals determine if the lung has healed sufficiently to manage its own pressure dynamics.
What to Expect with Chest Tube Suction
Living with a chest tube connected to suction involves several observations and sensations. You might hear a gentle, continuous bubbling sound if a wet suction system is in use, which indicates the suction is working correctly. The drainage collection chamber will show the amount, color, and consistency of fluid being removed from your chest, which healthcare staff will regularly monitor. In the water-seal chamber, you may observe the water level rising and falling with each breath, a movement known as “tidaling,” which confirms the system is connected to your lung.
Regarding physical sensations, it is common to experience some discomfort or a feeling of pressure at the chest tube insertion site. However, the suction itself is not painful, as it applies negative pressure to the pleural space, not directly to sensitive tissues. Pain management is an important aspect of care to ensure your comfort while the chest tube is in place. You should immediately report any new or worsening pain, difficulty breathing, significant changes in the amount or color of drainage, or if the chest tube appears dislodged, to your healthcare team.