Thoracostomy tubes: A comprehensive review of complications and related topics

Abstract

Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes.

Practical Aspects About Closed Chest Drainage Care: A Literature Review

“…The chest drainage also aims to maintain or restore the negative pressure of the pleural space [2][3][4]12,16,18,20 . For each case, there are 3 types of chest drainage systems for pleura effusion: (i) the closed drainage system; (ii) the open drainage system; and (iii) the suction drainage system [7][8][9][10][11][12][13][14][15][16][17][18][20][21][22] .…”

“…The fluid level in the underwater seal collector must be checked regularly, as well as its colour, consistency of the drainage contain 14,18 and air leak presence (bubbling) 9,20 . Medical staff needs to be notified if there is a sudden increase in amount of drainage greater than 5mls/kg in 1 hour or greater than 3mls/kg consistently for 3 hours [9][10][11]16,20 .…”

“…Therefore, clamping the tube must be avoid 7,9,20 regarding the same aspects, the description of techniques used to maintain drain patency (e.g. 'milking' as fanfolding the drainage tubing into segments and squeezing and 'stripping' as manual compression of the chest drain tubing from the chest wall towards the collection chamber often using a roller device) is not consensuous, thus not recommended 7,9,[14][15][16] . Source: developed by the authors Chest X-ray images after a chest drain insertion helps verifying its correct placement and evaluating the degree of the lung re-expansion and the residual pleural fluid and/or pneumothorax 7,11,20 .…”

“…The entire drainage system should be noticed: The insertion sutures that anchor the drain in place and the dressing on an attempting of not moving or removing the tube 11,14,20 . …”

Active bleeding from intercostal artery pseudoaneurysm after a percutaneous tube thoracostomy drainage procedure: diagnosis with CT angiography and treatment with transarterial coil embolisation

“…1 But when haemothoraces develops due to pseudoaneurysms, they could be timely detected by CT with CT angiography (CTA) and treated via transarterial embolisation with mini coils. 2 3 We report the case of a 9-year-old female child with medullobalstoma involving her brain and spine who was admitted for scheduled chemotherapy.…”