Chest Tube (Thoracostomy): Causes, Symptoms, Treatment and Cost

A chest tube (or thoracostomy) is a medical procedure used to drain air, fluid, or pus from the pleural space of the chest.

• Closed Chest Tube (Thoracostomy): This type of chest tube is inserted through a small incision in the chest wall and is then connected to a closed system. This type of chest tube is used to drain air, fluid, or pus from the pleural space and to provide temporary relief from pressure within the thoracic cavity.
• Open Chest Tube (Thoracostomy): This type of chest tube is inserted through an open incision in the chest wall and is then connected to an open system. This type of chest tube is used to drain air, fluid, or pus from the pleural space and to provide temporary relief from pressure within the thoracic cavity. It can be used for processes like lung biopsy or mediastinoscopy.
• Pigtail Chest Tube (Thoracostomy): This type of chest tube has a pigtail-shaped tip that allows it to be inserted into the pleural space more easily than other types of tubes. It can be used for both drainage and therapeutic purposes, such as providing access for instilling medications into the pleural space for treating infections or malignancies.

The benefits of chest tube insertion include:-

• Relief of symptoms: Chest tubes can help to relieve symptoms associated with pleural effusions, pneumothorax and other conditions by draining excess fluid or air from the chest cavity. This can reduce pain and discomfort associated with these conditions and improve breathing ability.
• Improved respiratory function: Chest tubes can help to restore normal lung function by allowing air or fluid to escape from the lungs and reducing pressure on them. This can help improve oxygenation levels in the blood and reduce shortness of breath caused by these conditions.
• Reduced risk of complications: Inserting a chest tube can reduce the risk of complications associated with pleural effusions, pneumothorax and other conditions as it helps to drain away any excess fluid or air from the chest cavity before it has time to cause any damage or infection.
• Improved quality of life: By relieving symptoms associated with pleural effusions, pneumothorax and other conditions, chest tubes can help improve quality of life for those affected by these conditions by allowing them to breathe easier and move around more comfortably without pain or discomfort related to their condition

Chest Tube (Thoracostomy) is usually performed in order to treat a pneumothorax (collapsed lung), hemothorax (blood in the pleural space), chylothorax (lymphatic fluid in the pleural space), or an empyema (pus in the pleural space).

• Infection: Whether the surgery is of any type ,the chances of infection are always there. any type of surgery is performed. This risk can be minimised by using sterile technique and antibiotics prior to and after the procedure.
• Bleeding: Chest tubes can cause bleeding if they are inserted too deeply or if blood vessels in the area are damaged during insertion.
• Air Leakage: Air may leak from around the chest tube if it is not properly sealed or secured to the chest wall. This can lead to pneumothorax (collapsed lung).
• Damage to Internal Structures: The chest tube may also damage internal organs or structures such as the heart, lungs, diaphragm, or ribs if it is inserted too deeply.
• Pain: Chest tubes may cause pain during insertion and while they are in place due to irritation of surrounding tissues and structures. Analgesics can be used to help manage this condition.

• Before your chest tube (thoracostomy) procedure, you should:-
• Talk to your doctor in case you are taking any medications including OTC medications and supplements. As the doctor may tell you to stop taking these medicines to prevent you from any complications.
• Ask your doctor regarding what not to do and what to eat and drink before the procedure.
• Make sure you have someone who can drive you home after the procedure is complete, as you will not be able to drive yourself home due to anaesthesia or sedation used during the procedure.
• Wear loose and comfortable clothes so that they can be easily removed at the time of procedure.
• Arrange for someone to stay with you at least 24 hours after the procedure is complete in case any complications arise and help is needed with daily activities such as bathing and eating.

• Chest tube (Thoracostomy) is done by inserting a thin, flexible tube into the chest cavity through an incision in the chest wall. The tube is then connected to a suction device that helps remove excess fluid or air.
• General anaesthesia is administered before the start of the procedure and can take up to two hours to complete.
• During the procedure, your doctor will make an incision in your chest wall and insert a thin flexible tube called a chest tube into your pleural space.
• The tube will be connected to a suction device that helps remove any excess fluid or air from the area.
• Once all of the excess fluid or air has been removed, your doctor will close up the incision and remove the chest tube.

• Explain the whole procedure to the patient and obtain informed consent of the patient.
• Prepare the patient by positioning them on their side or back, depending on the type of chest tube insertion being performed.
• The whole area should be cleaned with an antiseptic solution and cover it with sterile drapes to prevent any kind of infection
• Gather all necessary equipment for the procedure, including a chest tube, drainage system, suction device, and sutures for closure of incisions if needed.
• Administer local or general anaesthesia as needed for comfort and relaxation during the procedure.

• Make an incision in the chest wall to gain access to the pleural space (the space between two layers of tissue that lines each lung).
• Insert a chest tube through this incision into the pleural space and secure it in place with sutures if necessary.
• Connect one end of a drainage system to the chest tube and attach a suction device to maintain negative pressure within this system as needed (this is used to help drain air or fluid from within).
• Close any incisions made with sutures if necessary and apply sterile dressings over them for protection against infection while healing occurs over time
• Monitor vital signs throughout procedure as well as post-procedure in order to ensure patient safety at all times

• Protect the chest tube from any kind of damage.
• Check for air leaks
• Monitor the chest tube drainage
• Measure the amount of drainage
• Adjust suction as needed
• Change dressing as needed
• Monitor vital signs and chest wall movement
• Notify physician of any changes in drainage or patient condition

Generally, the cost for a chest tube (Thoracostomy) procedure ranges from Rs. 10,000 to Rs. 30,000.

• Foods that are easy to digest and high in protein, vitamins, and minerals are recommended.
• Food includes lean meats, fish, eggs, dahi, fruits and vegetables, whole grains, nuts and seeds.
• Eating several small meals throughout the day can help with digestion.
• It is necessary to have plenty of fluids to stay hydrated and help to eliminate toxins out from the body.

Yes, chest tube (Thoracostomy) is generally considered safe when performed by a trained healthcare professional. Complications can occur, such as infection or bleeding, but these are rare and can usually be managed with antibiotics and other treatments.

The recovery time depends on the condition of the patient. During this time, physical activity should be limited and monitored by a doctor.

The most common side effects of chest tube (thoracostomy) insertion include:-

• At the place of insertion, an occurrence of pain.
• Bleeding or bruising at the site of insertion
• Infection at the site of insertion.
• Pneumothorax is a collapsed lung condition that can occur.
• Air leaks from the chest tube.
• Damage to surrounding structures such as blood vessels and nerves.
• Allergic reactions due to medications or instruments used during the procedure.
• Pleural effusion is the condition in which there is fluid accumulation in the chest cavity.

• Monitor the chest tube drainage and keep a record of the amount of fluid drained.
• Keep the chest tube site and dressing clean and dry.
• Take your temperature every 4 hours and monitor for signs of infection such as redness, warmth, swelling, or drainage at the chest tube site.
• Avoid strenuous activity or lifting heavy objects until you have been cleared by your doctor to do so.
• Follow up with your doctor as recommended to have your chest tube removed when appropriate and to discuss any further treatment plans needed.

The chest tube (thoracostomy) is a procedure used to drain fluid or air from the pleural space surrounding the lungs. Conditions like pleural effusion, pneumothorax, and empyema can be corrected with the help of this procedure. As it is relatively safe and effective when performed by a trained medical officer. The recovery time of the patient varies depending on his or her condition and other factors too. Although it takes several days to weeks for the recovery process.