What Is a Chest Tube?

Reasons for a Chest Tube and Coping While You Have It

diagram of a chest tube insertion procedure
Chest tube insertion into the pleural space. A.D.A.M. Medical Encyclopedia

Chest Tube - Definition

A chest tube is a hollow plastic tube which is inserted into the chest cavity to drain air or fluid. Fluid in the chest may be blood (such as following surgery or trauma), or pus (from an infection such as pneumonia).

When are Chest Tubes Used?

A chest tube may be inserted for several reasons:

  • To re-expand the lungs when a lung collapses (pneumothorax). With a pneumothorax, the tube is inserted into the pleural cavity - the space between the membranes (pleura) that line the lungs
  • After surgery for lung cancer to drain fluids that remain in the space created after a portion of a lung is removed
  • For pleural effusions - both benign and malignant pleural effusions (see below)
  • After heart surgery
  • If there is bleeding into the chest (hemothorax), for example, from trauma
  • To drain pus from an infection or abscess (empyema)

Chest Tube Placement

When a chest tube is inserted for a collapsed lung, a small area on the chest is numbed by using a local anesthetic. The tube is then inserted, and connected to a machine which uses suction to remove the air, thus allowing the lung to re-expand. The tube is sutured in place so it won’t pull out with movement.

When a chest tube is inserted after surgery, it is placed under general anesthesia in the operating room. The tube is then connected to a container lower than the chest, using gravity to allow the excess fluids to drain.

How Long are They Left in Place?

The amount of time a chest tube will remain in place can vary depending on the reason it is placed, and how long an air leak or fluid drainage continues.

With a pneumothorax, doctors will look at an x-ray to make sure all of the air has been removed, and the lung has expanded completely. Following lung cancer surgery, the tube will be left in place until only minimal drainage remains, often a period of three to four days.

Chest Tube Removal

Removal of a chest tube is usually a fairly easy procedure and can be done comfortably in your hospital bed without any anesthesia.

The sutures are separated and the tube is then clamped. Your doctor will ask you to take a breath and hold it, and the tube is pulled out. The suture is then tied to close the wound and a dressing applied. If the tube was placed for a collapsed lung, an x-ray will be done to make sure the lung remains expanded after removal.

Pleural Effusions in People with Lung Cancer

Pleural effusions are very common in people with lung cancer. In a pleural effusion, fluid builds up in the pleural space, the area between the two pleural membranes that line the lungs.This space usually contains only three to four teaspoons of fluid, but with lung cancer, several liters of fluid may accumulate, or re-accumulate, quite rapidly.

When cancer cells are present in a pleural effusion, it is termed a malignant pleural effusion. If a malignant pleural effusion is present, it categorizes lung cancer as stage 4.

Many people with lung cancer end up having recurrent pleural effusions - and even though these are often benign, the pressure on the lungs from excess fluid causes pain and shortness of breath.

There are many options when this occurs. Sometimes a shunt is placed from the pleural space into the abdomen so that the fluid is able to continuously drain. This option may be better than having recurrent thoracentesis (when a needle is placed into this space) to drain the fluid.

Another option for recurrent pleural effusions is to scar down the space between the two pleural membranes. This procedure is called a pleurodesis and is done in the operating room under general anesthetic.

Coping with a Chest Tube

Having a chest tube in place no matter the reason is very frustrating. For whatever reason air or fluid has accumulated in the pleural space, the time waiting for it to resolve and not knowing is difficult both for patients and their loved ones. Talk to your doctor about your feelings, and ask for an estimate on the time it will be left in place. Be your own advocate and ask questions. Medicine is changing and patients and physicians are working much more closely together than in the past when it comes to making decisions about health care options.


National Institute of Health. Medline Plus. Chest tube insertion. Updated 04/13/15. https://medlineplus.gov/ency/article/002947.htm

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