Article Sections

Introduction

Chest tubes are essential tools for the treatment of pneumothoraces and pleural effusions.  Practiced since the time of Hippocrates (ca. 400-500 BC), their fundamental operation has changed very little.  This article covers major aspects of chest tube management, including indications for use, insertion techniques, initiation, weaning, removal, and troubleshooting of common issues.

The 3-chamber system

Modern chest tube collection systems consist of a chest tube and a 3-chamber drainage system ( Figure 1), also shown in the cutaway ( Figure 2).  The drainage system consists of a collection chamber, a water seal chamber, and a suction regulation chamber.

Collection chamber

The collection chamber is the first section of the drainage system, where fluid or blood from the pleural cavity is gathered.  It has graduated markings to monitor the volume of drainage over time.

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