A chest tube is a flexible, hollow plastic tube inserted into the space between the lung and the chest wall, known as the pleural space. It manages the pleural space after thoracic surgery. Its primary purpose is to drain unwanted substances and maintain proper lung function.
Why Chest Tubes Are Essential After Thoracic Surgery
Thoracic surgery often necessitates opening the chest cavity, which can lead to the accumulation of air, blood, or other fluids in the pleural space. This accumulation can prevent the lung from fully expanding, leading to breathing difficulties and other complications. Conditions like pneumothorax, an accumulation of air, or hemothorax, a collection of blood, can directly result.
Fluid buildup, known as pleural effusion, can also occur, where excess fluid compresses the lung. These issues disrupt the natural negative pressure within the pleural space, which is necessary for the lungs to expand and contract properly. By providing a pathway for drainage, chest tubes help re-establish this negative pressure, allowing the lung to re-expand fully and preventing serious postoperative complications.
How Chest Tubes Function
A chest tube is inserted through the chest wall into the pleural space and then connected to a closed drainage system. This system includes a collection chamber, a water seal chamber, and sometimes a suction control chamber. The primary function is to drain excess air, blood, or fluid that accumulates around the lung.
The collection chamber gathers the drained substances, allowing healthcare providers to monitor the volume and type of drainage. The water seal chamber acts as a one-way valve, permitting air and fluid to exit the chest while preventing outside air from re-entering. This mechanism helps restore and maintain the normal negative pressure within the pleural space, which is important for lung expansion and efficient breathing.
Some systems also incorporate a suction control chamber, which applies gentle suction to facilitate drainage and promote lung re-expansion. The entire system must be kept below the patient’s chest level to allow gravity to assist with drainage and prevent backflow into the pleural space.
Living With and Removing Chest Tubes
Patients with chest tubes may experience some discomfort or pain at the insertion site, which can be managed with pain medications. Movement restrictions may be in place, but patients are encouraged to walk with portable drainage systems to aid recovery. Healthcare providers closely monitor the amount and type of drainage, as well as the patient’s breathing and lung sounds, to assess progress.
Chest X-rays are routinely performed to check the lung’s re-expansion and the tube’s position. The duration a chest tube remains in place varies, but it is a few days. The tube is removed when drainage significantly decreases and there is no longer an air leak present.
The removal process is quick and performed after administering pain medication to minimize discomfort. Patients may be asked to perform a specific breathing technique as the tube is withdrawn to prevent air from entering the chest. After removal, an occlusive dressing is applied to the site, and follow-up imaging may be done to confirm proper healing and lung stability.