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Chest Tube

Chest tube thoracostomy is a procedure where a special drain, termed a chest tube, is introduced into the pleural cavity. The pleural cavities are the two large cavities that contain the lungs. Usually, there is no air and only minimal lubricating fluid in these cavities. Chest tubes are inserted most commonly to drain abnormal air (pneumothorax) or excessive fluid from the pleural space.

The patient is usually positioned so that the side requiring the chest tube is facing upward. An area between two ribs is sterilely prepared with a topical antiseptic and then infiltrated with a topical anesthetic such as lidocaine. A small incision is made and then the tube is advanced between the ribs and into the pleural space. The chest tube is finally secured in place by sutures and connected to a fluid collection system.

Once in place, the amount of fluid drainage and the presence or absence of an ongoing leak of air is monitored by the physician. When the physician is satisfied that these amounts are not excessive, the tube is removed at the bedside.

Aside from discomfort at the insertion site, complications of chest tubes are uncommon. These may include bleeding, infection, or subcutaneous emphysema (air tracking into the chest wall itself - usually a relatively harmless occurrence).

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