Chest Tube Placement and Management: A Practical Review

Abstract

Percutaneous chest tube placement is a relatively common procedure that can be performed by multiple specialties. Chest tube insertion is frequently performed by interventional radiologists (IRs) due to the advantage of imaging guidance including ultrasound (US), fluoroscopy, and computed tomography (CT) which allow for precise placement not achieved with bedside insertion techniques. Chest tube management is increasingly conducted by IRs, signifying the importance of a greater understanding of chest tube management and troubleshooting, especially for IR trainees. This manuscript is specifically tailored for the IR trainees to provide an overview of chest tube management. The practical considerations detailing the entire chest tube process are covered such as indications, technique, relevant anatomy, collection devices, commonly used catheters, postprocedural complications, lytic therapy, and troubleshooting. This guide aims to help the IR trainees feel more confident in chest tube placement and periprocedural care.