![]() The chest tube should initially be set to continuous suction at -20 mmHg to evacuate the air. If the patient has a pneumothorax, air bubbles will be visible in the water chamber called an air leak, these are often more apparent when the patient coughs. ![]() The interventional radiologist or surgeon who placed the tube should determine the subsequent frequency of serial chest X-rays required to monitor the location of the chest tube. Respiratory variation in the fluid in the collecting tube, called “tidling,” should also be seen in a correctly placed chest tube, and should be monitored at the bedside to reassure continued appropriate location. Chest tubes are equipped with a radiopaque line along the longitudinal axis, which should be visible on X-ray. Chest tubes are also commonly placed at the end of thoracic surgeries to allow for appropriate re-expansion of the lung tissue.Ī chest X-ray should be obtained after any chest tube insertion to ensure appropriate placement. Pneumothorax and hemothorax usually require immediate chest tube placement. Indications for a chest tube include pneumothorax, hemothorax, or a persistent or large pleural effusion. The third chamber is the collection chamber for fluid drainage. The suction chamber can be attached to continuous wall suction to remove air or fluid, or it can be placed on “water seal” with no active suction mechanism. The water chamber holds a column of water, which prevents air from being sucked into the pleural space with inhalation. The tubes are connected to a collecting system with a three-way chamber. Chest tubes are typically placed between the fourth and fifth intercostal spaces in the anterior axillary or mid-axillary line however, the location may vary according to the indication for placement. They can be as thin as 20 French or as thick as 40 French (for adults). Chest tubes are placed in the pleural space to evacuate air or fluid. The lung re-inflates naturally when this air is withdrawn using the chest drain being inserted here. The lung collapse was done by opening up the pleural cavity to air from outside. The lung was originally collapsed to allow access to the chest organs during surgery. Lung re-inflation after surgery, using a chest drain.
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