Interventional Radiology: Chest
Chest Tube

A chest tube may be placed to drain or sample fluid or remove air around the lungs (pleural) for multiple reasons. Chest tubes may be used to drain fluids possibly present from infection (empyema). In these circumstances, a relatively large chest tube may be placed by a pulmonologist or an intensivist at the patient's bed side. Depending on the location and quantity of the fluid present, a chest tube may be placed under CT or ultrasound imaging guidance by a radiologist to sample and relieve the fluid.

If placement of a chest tube by a radiologist is selected, the area of concern is located under CT or ultrasound and local anesthetic and conscious sedation are administered. The procedure involves placement of a needle into the fluid followed by placement of a tube through the needle tract, which is left in place until the fluid has completely drained (usually a few days, possibly a week).

Chest tubes are also used to remove a pneumothorax, an air leak from the lung into the area between the lung and the chest wall (pleural space). Pneumothorax, a serious complication of a procedure, can cause the lung to collapse. A tube, relative to the size of the leak may be placed in the chest and connected to a small valve (Heimlich tube) that only lets air out (rather than in). When the patient takes a breath, the air that is leaked from the lung is forced out of the tube to re-expand the lung. The chest tube is left in place until the air leak seals (usually 1 to 3 days). The patient is generally hospitalized during this time, but may be able to go home if the tube is small.