Chest Tube Drainage of the Pleural Space

Chest tubes are commonly used to drain fluid following surgery involving the pleural space. Removal can be considered when there is no empyema or air leak, and fluid drainage has decreased to an acceptable level. Patients are rarely discharged from the hospital with a chest tube, so earlier removal could result in shorter hospital stays. 

Patients undergoing an open thoracotomy with routine chest tube placement were randomized to chest tube removal at an uninfected chest tube drainage volume of fewer than 200 mL per day, less than 150 mL per day, or less than 100 mL per day.

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The surgeons concluded that using a drainage threshold of 200 mL per day for chest tube removal in patients with uninfected pleural fluid and no evidence of air leaks may safely decrease costs and length of stay following thoracic operative procedures. Further studies are recommended to evaluate thresholds of even higher volume per day for chest tube removal.

Hence, the chest tube most often stays in place until x-rays show that all the blood, fluid, or air has drained from your chest and your lung has fully re-expanded. The tube is easy to remove when it is no longer needed.

Some people may have a chest tube inserted that is guided by x-ray, computerized tomography (CT), or ultrasound. If you have major lung or heart surgery, a chest tube will be placed while you are under general anesthesia (asleep) during your surgery.