A chest tube is a long hollow tube inserted between the ribs and into the pleural space. An underwater seal drain (UWSD) is the specialized drain, which is attached to the chest tube. Chest tubes are normally inserted under a local anaesthetic or under a general anaesthetic if the patient is undergoing chest surgery.
"The two common complications are the risk of infection and pain."
How does it work?
A chest tube is inserted to drain either extra air and / or fluid (including blood) from the pleural space. Once the chest tube is attached to the UWSD system the air or fluid ‘bubbles’ through the water seal inside the drain. This water seal acts as a one-way valve and prevents the air or fluid going back into the pleural space
Why or what is it used for?
The pleural space is the space between the two layers of pleural tissue (visceral and parietal), which line the inside of the chest cavity, and lungs. The two layers are held together by a small negative pressure or vacuum. This keeps the lungs inflated. The pleural space is normally empty except for a small amount of fluid. Air or fluid may accumulate in the space under a number of circumstances including during chest surgery, as a result of chest trauma, pneumonia or some intraabdominal conditions. A pneumothorax or air in the pleural space (sometimes referred to as a ‘collapsed lung’) can also occur spontaneously. The fluid or air can accumulate rapidly or slowly over a number of days. This air or fluid may lead to an increased difficulty in breathing for a patient. If both fluid and air need to be drained the patient may require 2 chest tubes.
A pleural effusion is a fluid collection in this space. A haemothorax is a collection of blood in this space. A haemopneumothorax is a combination of blood and air in this space.
How long will it be used for?
Chest drains normally remain in so long as the air or fluid remains in the pleural space. The patient will have regular chest x-rays to monitor the resolution of the problem.
Are there any complications?
All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. The two common complications are the risk of infection and pain. As with any drains inserted into the body there is a risk of infection so it is important that neither the patient nor relatives touch the drains, tubes or dressings covering the insertion site at the chest. Good hygiene practices including washing hands before contact with the patient will help to minimize the infection risk. There can be a degree of pain and pain relief is individualized according to different patient needs and should be discussed with the doctors and nurses caring for the patient.
Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.