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Chest Tube Insertion

(Tube Thoracostomy)


Rebecca Dezube

, MD, MHS, Johns Hopkins University

Last full review/revision May 2021| Content last modified May 2021
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Chest tube insertion (also called tube thoracostomy) is a procedure in which a tube is inserted into the space between the lung and chest wall (called the pleural space).

The procedure is done to drain air from the space if the lung is collapsed (a condition called pneumothorax Pneumothorax A pneumothorax is the presence of air between the two layers of pleura (thin, transparent, two-layered membrane that covers the lungs and also lines the inside of the chest wall), resulting... read more Pneumothorax ). It is also sometimes done to drain fluid from the pleural space (called pleural effusion Pleural Effusion Pleural effusion is the abnormal accumulation of fluid in the pleural space (the area between the two layers of the thin membrane that covers the lungs). Fluid can accumulate in the pleural... read more Pleural Effusion ), particularly if the fluid accumulates continually so that it cannot be drained all at once. In some situations, insertion of a chest tube is an emergency, potentially life-saving procedure.

Chest tube insertion is done with the person awake, although sometimes a sedative is given. The doctor anesthetizes the area between two ribs and then makes a small incision and inserts the tube. The tube is connected to suction. A chest x-ray Chest imaging studies include X-rays Computed tomography (CT) CT angiography Magnetic resonance imaging (MRI) read more is usually done after the tube is inserted to confirm correct placement. Severe complications are infrequent. They can include chest pain, puncture of the lung or diaphragm, accumulation of air under the skin, and infection. If a large amount of fluid that has been present for weeks to months is withdrawn rapidly, fluid can accumulate within the lung itself (pulmonary edema). Occasionally, a tube needs to be replaced because it kinks, becomes dislodged, or becomes blocked by a blood clot.

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