Is Bedside Ultrasound Useful for Chest Tube Removal? Description of an Initial Experience
A small amount of fluid in the space between the lungs and the chest helps the lungs move
without friction during respiration. But a build-up of air (pneumothorax), blood (hemothorax),
or pus (pyothorax) from injury, disease, or surgery can prevent the lungs from fully expanding.
Partial or total collapse of the lungs compromises breathing and can lead to respiratory arrest.
Insertion of a chest tube, also known as a thoracostomy tube or thoracic catheter, can bring
rapid relief.
Most problems resolve within a few days, as the closed water-seal drainage device
that’s attached to the tube suctions off the abnormal accumulation of fluid or air and helps
restore the negative pressure in the affected lung. No matter what the reason for the insertion,
a chest tube must be removed within one week.
Leaving it in place longer than 7 days raise the risks for infection along the
chest tube tract.1 A number of clinical indicators will determine
when a patient is ready for his chest tube to be removed.
If the chest tube was inserted because of excess fluid, it can be safely
removed when the drainage is less than 200 ml in 24 hours.
If blood precipitated tube insertion, minimal output and a change
in drainage from bloody to serous or serosanguinous is also
a key indicator.
In the case of pneumothorax, the tube can be safely removed when bubbling
or fluctuation in the water-seal chamber ceases during expiration or during a cough.
Emerg Med Open J. 2017; 3(2): 38-41. doi: 10.17140/EMOJ-3-138
