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Chest tubes: indications, placement, management, and complications
T B Gilbert1, B J McGrath, M Soberman
1University of Maryland Medical Center, Department of Anesthesiology, Baltimore.
Journal of Intensive Care Medicine
|January 8, 1993
Summary
Tube thoracostomy, a common procedure in intensive care units, involves chest tube insertion for draining air or fluid from the pleural space. Proper training is crucial to minimize complications associated with this intervention.
Area of Science:
- Critical Care Medicine
- Thoracic Surgery
- Pulmonology
Background:
- Tube thoracostomy is a frequently utilized procedure in intensive care units (ICUs).
- Intensivists play a key role in the management of chest tubes, including insertion, maintenance, and removal.
- Advances in technology have enhanced the safety and efficacy of tube thoracostomy.
Observation:
- Chest tubes are indicated for various conditions such as spontaneous or iatrogenic pneumothoraces, hydrothoraces, and effusions (pus, bile, chylous).
- The procedure involves placing a tube into the pleural space to evacuate abnormal collections.
- Management encompasses insertion techniques, equipment selection, and drainage systems.
Findings:
- Current indications for chest tube placement are reviewed.
- Insertion techniques and available equipment, including drainage systems, are discussed.
- Guidelines for the maintenance and discontinuation of chest tubes are provided.
Implications:
- Tube thoracostomy is a versatile tool for managing diverse thoracic pathologies in critically ill patients.
- Understanding insertion techniques and equipment is vital for successful outcomes.
- Adherence to guidelines and proper training can mitigate potential complications, improving patient safety.