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What is A Chest Tube Placement for?

What is a Chest Tube Placement for? (Respiratory Care USA)

A chest tube placement is used to extract (drain) any substance that has penetrated the pleural cavity to relieve the pressure and help re-expand and inflate the lungs back up again before the lung collapse worsens.

It is inserted and placed to help recover lungs’ normal function and expansion when there is a respiratory difficulty or lungs failure, to prevent the lungs from collapsing. Most commonly put after a trauma or a life-threatening respiratory diagnose when air, fluids or gas penetrate the lungs and cause a pneumothorax. A chest tube is placed after a pneumothorax, or if there is a diagnosed situation that compromises lungs normal function.

This medical procedure needs to be done to help re-inflate the collapsed lung when the parietal pleura is damaged or injured, and the lung is compressed not allowing its natural expansion. This situation compromises normal breathing (inhaling and exhaling) function, and if not practiced it can become critical and life-threatening.

The chest tube placement is also known as thoracostomy or intercostal drain
~ Helps relief the pressure after a pneumothorax has been detected (diagnosed) to support the collapsed lung re-inflate again before it gets worse.
~ It also allows and helps recover the full re-expansion of the lung and improve oxygen transfer.
If a pneumothorax worsens the oxygen transfer to the bloodstream and cells will be compromised

The chest tube is placed to:

~ Extract fluids, air, gas, blood or pus accumulation in the space between the visceral pleura and the parietal pleura (pleural space).

  • Visceral Pleura is the one that covers the lungs surface.

  • Parietal Pleuralis the one that covers the pleural cavity surface. (The one between the pleural space and the chest cavity).

~ Inject medications that artificially help remove the pleural space: inflating both the parietal and visceral pleura making them stick together and remove the space between them (the pleural space) to prevent regular fluid accumulation. This chest tube placement use and the procedure is called Pleurodesis.

Also used to inject fibrinolytic agents, deoxyribonuclease (DNase) in the pleural space to dilute (thin) thick substances and help improve the drainage of the fluid. Can be practiced to drain pleural infections.

The chest tube placement is a minimally invasive surgical lifesaving procedure that can be performed by a doctor at a healthcare facility emergency or operating room or by a critical care paramedic at an accident site.

A small insertion is done under the armpit between the 4th and 5th rib space, on the side where the collapsed lung is suspected or diagnosed (after obtaining the x-ray image). Then the chest tube is inserted and placed following all the necessary antiseptic procedure. After it is set correctly the outside side of the tube is connected to the draining device to start the substance extraction process.

~ To drain air, the chest tube is placed towards the upper lung space area.

~ To remove fluid, the chest tube is situated at the lung base.

A chest tube placement is needed when the following respiratory complications or problems are diagnosed:.

    • Pneumothorax

When gas or air penetrate the pleural space and lung collapses due to a trauma, a car accident, a chest stroke during a sport, lung disease or a surgical complication, also during air pressure changing experiences like scuba diving or climbing, when blebs or small sacks of air are formed in the lungs tissue causing ruptures letting air enter the pleural cavity causing the collapse.

    • Hemothorax

When blood penetrates the pleural space compromising lungs function due to a stab wound, gunshot, significant impact, a sharp object trauma or chest surgery complication.

    • Pleural Effusion or Empyema

When there is fluid or pus accumulation in the pleural space due to pulmonary infection, pneumonia, bronchitis, viral infection (HIV), chronic obstructive pulmonary disease (COPD), asthma, pulmonary embolism, or lung cancer.

    • Valve artificial ventilation failure

When air keeps on pumping inside the pleural space (between the lungs and the chest wall) but it doesn’t come out, due to a valve failure. Continually inflating putting more pressure and expanding the area.

This Pneumothorax pressure needs to be relieved quickly before if pushes the trachea and heart and collapses the other lung, to help prevent a fatal situation.

The chest tube placement or thoracostomy is an emergency practiced procedure in most cases because it can lead to a life-threatening situation if not done in time.

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