Chest Tube Procedure
Last Updated 05/07/2020
Authors:Hitesh Batra, MD; W. Awori Hayanga, MD, MPH; Olugbenga T. Okusanya, MD; Jay Peters, MD, FCCP; Ian Nathanson MD, FCCP
About Chest Tubes
- Chest tubes are inserted surgically into the chest to relieve pressure caused by fluid or air around the lungs.
- Tubes come in a variety of shapes and sizes.
Air or fluid (such as blood or pus) that collects in the pleural space—that is, the space between your lungs and your chest wall—can cause your lung to collapse. A chest tube is a plastic tube that a health care provider inserts to drain this fluid or air from your chest. Chest tubes can be inserted at the end of a surgical procedure while you’re still under anesthesia and asleep or at your bedside using pain medication and a local anesthesia. Chest tubes come in a variety of shapes and sizes, from as small as a shoelace to as large as a highlighter.
Chest tubes are usually connected to a drainage system that collect fluid and allows air to escape from the chest. These systems can allow the air or fluid to drain on its own (passive) or apply suction to draw the air or fluid out.
What to expect
What to expect when the tube is inserted
If you’re awake when your health care provider inserts the chest tube, he or she will give you pain medication and local anesthesia at the site of insertion. You may also get medication to help ease your anxiety. Your provider will do everything possible to make the procedure tolerable, but you will probably still have some discomfort.
Depending on the chest tube, the provider will use one of the following procedures:
- Gently cut and spread open the skin and muscles of the chest wall, then insert the tube.
- Insert a wire into the chest through a needle. The wire then acts as a track for the chest tube to follow.
Regardless of the procedure used to place the chest tube, patients often report some discomfort because the tube lies on the ribs and moves slightly with each breath. This discomfort is usually temporary.
The goal of the procedure is to drain the pleural space. Therefore, you can expect to see or feel the fluid or air leaving your chest. You may even feel your collapsed lung re-expand. After the procedure, your provider may order a chest X-ray to see how much air or fluid has been drained, how much the lung has re-expanded, and what the final position of the chest tube is.
What to expect when the tube is removed
Chest tubes are kept in place by stitches, and then covered with a sterile dressing. Mild discomfort at the surgical site is common. If you have severe pain or difficulty breathing, call for help right away.
Chest tubes can stay in for several days. On rare occasions, patients can been sent home with a chest tube. Typically, though, the tube is removed in the hospital when the amount of fluid draining from the tube is low or no more air escapes through the tube.
To remove the tube, your provider cuts the stiches that hold it in place. You may have mild discomfort as the tube is removed.
What are the risks?
Serious complications during chest tube insertion are uncommon, but you may still experience:
- Pain during insertion and after placement of the chest tube
- Improper tube placement
- A dislodged chest tube
- Collapsed lung after removal of the chest tube
- Bleeding at the insertion site
- Bleeding into the pleural space
- Injury to the lung
- Injury to other organs, such as the heart, spleen, liver, or diaphragm