What Is a Chest Tube?
A chest tube, also known as a Thoracic drainage tube, It is a flexible tube inserted into the chest to drain air, blood, or other fluids from the pleural
space—the space in the middle of the lungs and the chest wall. It’s perticularly used to treat conditions such as pneumothorax (collapsed lung), hemothorax (blood in the chest cavity), pleural effusion (build-up of fluid), or to facilitate post-operative drainage after special chest surgeries.
The chest tube is inserted through a small cut made in the middle of the ribs into the pleural space, and its other side is connected to a drainage system, which may be made of a collection chamber and a one-way gate to prevent air or fluid from flowing back into the chest. The negative pressure created by the drainage system helps remove air or fluid, allowing the lung to helping in the re-expand and preventing complications associated with trapped air or fluid in the chest cavity.
1.Preparation:
- The patient is either lying down on their back or propped up just a bit.
- Make sure the area where we’ll be working is super clean and germ-free. Usually, this is on the side of the chest. We create a safe and clean space around there to do the procedure.
- Before starting, Need to give some numbing medicine right where we’re going to put the tube. This helps make sure you don’t feel any pain during the procedure.
2. Incision:
- Make a tiny cut in the skin, usually on the side of the chest, kind of near the armpit area, between the ribs.
- This spot is chosen carefully to avoid hitting any important stuff like blood vessels or nerves.
3. Accessing the Pleural Space:
- Gently make a path through the layers of skin, tissue, and muscle until we reach the space around the lungs.
- Carefully not to hurt anything important nearby.
4. Insertion of Chest Tube:
- Once reached the space around the lungs, there might use a special tool called a trocer or a blunt-tipped dilator to make a bigger opening.
- After made the opening in the skin, we slide in a flexible tube. This tube has tiny holes along its sides to help drain out any extra fluid or air.
- We might hook up the tube to a system that helps to drain out any fluid or air from around the lungs. This system makes sure that everything flows out smoothly, helping the patient feel better faster.
5. Confirmation and Securing:
- Once the chest tube is put in, we double-check to make sure it’s in the right spot. Sometimes, we can just look and see that it’s where it should be. Other times, we might need to take an X-ray to be absolutely sure.
- Once the tube is in the right spot, we make sure it stays there securely. We might use stitches, special tape, or a special device to keep it in place.
6. Monitoring and Post-procedural Care:
- After we put the tube inside the patient, we keep a close eye on the patient’s breathing, their Important signs like heart rate and blood pressure, and how much fluid is draining out through the tube.
- If any issues occur like a collapsed lung, bleeding, or infection, we take care of them right away. We keep a close eye on everything to make sure the patient stays safe and comfortable throughout the whole process.
- We keep an eye on how much fluid is draining out and make sure the chest tube is doing its job right. This means checking regularly to ensure everything is working as it should be.
- ◦After the chest tube is inserted, the patient will be monitored closely to ensure everything is going well, and any necessary care will be provided based on their condition and the reason for the tube insertion.
What Are the Risks?
Inserting a chest tube is usually safe and works well, but like any medical procedure, it can have some risks. Here are some things that could go wrong at the time of insertion a chest tube:
Bleeding: When a chest tube is inserted, there’s a chance that bleeding could happen either where the tube is put in or inside the chest. This risk is higher for people who already have bleeding issues or are taking medications that make their blood thinner.
Infection: At the time of chest tube insertion, it makes a way for bacteria to get inside your body, which raises the chance of getting an infection. This infection could cause problems like pneumonia or an infection right where the tube inserted.
Pneumothorax: Sometimes, at the time of chest tube insertion, it can accidentally lead to a condition called pneumothorax. This happens when air gets into the space around the lungs, causing the lung to collapse even more. It’s not common, but it’s something that doctors watch out for during and after the procedure.
Subcutaneous emphysema: Air can escape into the tissues just beneath the skin. When this happens, it can lead to a condition called subcutaneous emphysema. This might cause the affected area to swell and feel like it’s crackling when touched.
Organ injury: Basically, there’s a chance that when they’re inserting with the chest tube, they might accidentally hurt other nearby organs like the lung or liver.
Pain and discomfort: After the procedure, some people might feel pain, discomfort, or tenderness where the chest tube was inserted in their chest.
Tube malposition: Sometimes the chest tube might not be placed correctly. This can result in problems with draining fluid or air from the chest, or it could cause other complications.
Re-expansion pulmonary edema: When a collapsed lung is re-expanded, it can cause a condition called re-expansion pulmonary edema. This means that fluid builds up in the lungs, which can be quite serious.
What are the benefit of chest tube?
The benefits of a chest tube depend on the specific condition being treated, but in general, here are some primary benefits include:
Improved lung function: It can help fix a collapsed lung by making it expand again, or it can take out extra fluid that’s squishing the lung. When that happens, it makes breathing easier and helps your lungs work better.
Prevention of complications: If conditions like a collapsed lung (pneumothorax) or blood in the chest (hemothorax) aren’t treated, they can cause serious problems. Chest tubes stop these problems by taking out the air or fluid from the chest, which helps the lung expand again and work like it should.
Relief of symptoms: Conditions such as pleural effusion (build-up of fluid) can cause symptoms such as chest pain, difficulty breathing, and coughing. By draining the excess fluid from the pleural space, chest tubes can help alleviate these symptoms and improve the patient’s comfort and quality of life.
Facilitation of treatment: Chest tubes may be used to facilitate other treatments or procedures, such as pleurodesis (a procedure to prevent recurrence of pleural effusion) or thoracic surgery. By draining air or fluid from the chest cavity, chest tubes help create a better environment for these treatments to be effective.
Prevention of recurrence: when someone keeps getting pneumothorax (a collapsed lung) or pleural effusion (build-up of fluid around the lungs), doctors will use chest tubes as part of the treatment. Chest tubes help by draining out air or fluid from the space around the lungs. It can stop more air or fluid from building up and lower the chances of the problem happening again.
The benefits of a chest tube include improving lung function, preventing complications, relieving symptoms, facilitating treatment, and reducing the risk of recurrence for certain chest conditions.