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Chest tube thoracostomy, commonly referred to as “putting in a chest tube”, is the insertion of a hollow plastic tube into the pleural cavity (space around the lungs) to drain air, blood, pus or other fluids. Whether the excess air or fluid is the result of a traumatic injury, cancer, pneumonia or another condition, insertion of a chest tube allows for “continuous, large volume drainage” until the underlying condition that’s causing the build-up can be properly addressed.
There are a number of reasons why a chest tube may be needed. They include:
Usually, the accumulation of air or fluid around the lungs is identified with a chest X-ray, although a chest ultrasound or CT scan may also be used. If the X-ray shows the need for air or fluid to be drained, a surgeon, pulmonologist, critical care doctor or interventional radiologist will be called upon to perform the procedure. Adults and older children usually remain awake during the procedure. Young children may be given a sedative to keep them calm.2
The skin will be cleansed and a local anesthetic will be injected to numb the area between the ribs where the chest tube will be inserted. A small incision will be made and the chest tube will be inserted through that incision. The doctor will guide the tube into the chest and then stitch it into place to prevent it from slipping out. A sterile dressing will be placed over the insertion site and changed according to the doctor’s instruction. 2
Most patients stay in the hospital the entire time the chest tube is in place. After it’s inserted, it will be attached to a suction machine unit that will gently extract the mucus or other bodily fluids from the chest cavity. Hospital staff will check the chest tube frequently to make sure there are no air leaks or plugging of the tube. They will also assess your breathing, which should improve once the chest tube is in place. If there are no complications, there will be less and less drainage every day until at which time there is minimal to no drainage at all and the chest tube will be removed.2
The risk of complications from chest tube placement are minimal; less than 5 percent. Your doctor should explain possible risks and complications before you sign consent for the procedure. Below are some possible risks/complications your doctor may review with you: 2
Once your doctor determines the chest tube is no longer needed, it will be removed. This procedure takes only a few minutes and is usually done at the bedside. There will be a dressing over the insertion site and your doctor will give you instructions on how and when it should be changed or removed. You will most likely have a follow-up visit with your doctor, at which time you may have to have another chest X-ray. This is just to make sure the air or fluid hasn’t returned. Once the incision site heals, you will have a small scar.2
For more information about why you may need a chest tube, talk to your primary care provider or your pulmonologist.
 Shlamovitz, Gil Z., MD, FACEP, et. al. Tube Thoracostomy. Medscape. Updated September 13, 2016.
 American Thoracic Society. Chest Tube Thoracostomy. Accessed November 25, 2017.