Abstract
A thoracostomy tube (or chest tube) is a hollow plastic tube or catheter that is used to drain air, fluid, pus, or blood from the intrathoracic space. Indications for a chest tube include pneumothorax, hemothorax, and pleural effusions. The size of the tube usually depends on the indications for the procedure (pneumothorax vs. effusion), the effusion characteristics (transudate vs. exudate), and patient condition. Most chest tube insertions are completed bedside by pulmonologists, intensivists, emergency room physicians, interventional radiologists, or general, trauma, or thoracic surgeons. Relative contraindications to chest tube placement include use of anticoagulant medications, coagulopathy, bleeding disorders, diaphragmatic hernia, or overlying infection. Complications of chest tube placement include hemorrhage, infection, or inadvertent laceration of the liver or spleen. Medication implications focus on cases of recurrent effusion when chest tubes may be used to administer sclerosing agents such as doxycycline, talc, or bleomycin into the pleural space for chemical pleurodesis.
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