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Chest tubes. Indications, technique, management and complications
KS Miller and SA Sahn Chest 1987;91;258-264

The online version of this article, along with updated information and services can be found online on the World Wide Web at: http://chestjournal.org

CHEST is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright 2007by the American College of Chest Physicians, 3300 Dundee Road, Northbrook IL 60062. All rights reserved. No part of this article or PDF may be reproduced or distributed without the prior written permission of the copyright holder (http://www.chestjournal.org/misc/reprints.shtml). ISSN: 0012-3692.

Downloaded from chestjournal.org on August 10, 2007 Copyright © 1987 by American College of ChestPhysicians

review
Chest Tubes*
Indications,
K. Scott Miller,

Technique,
M.D.;t and

Management
Steven A. Sahn,

and Complications
M.D., FC.C.P1

O
tion,

yen the techniques

past

ten greatly. biopsy,

years,

the to the

spectrum pulmonary

of diagnostic physician with aspiraexemplify

the being

1860s,

developed into

a hypodermic the pleural

needlespace for

capable drainage

of

available

inserted

has expanded transbronchial and newly

Fiberoptic transbronchial laser

bronchoscopy needle

developed

applications

purposes. Playfair’ placed a drainage tube with an underwater seal in 1872, and Hewitt4 described closed tube drainage ofan empyema in 1876. Due to technical problems, until 1917 postinfluenzal tubesLilienthal thoracotomy acostomy place until the procedure was not employed widely when it was successfully epidemic empyemas.5 thoracic Although care used in
1922.6

one aspect of the explosion. biopsy and thoracoscopy are scope of invasive techniques pulmonologist. tients often monitoring the ing price complications, Present-day requires invasion and administration of this invasion particularlyPercutaneous needle examples of the wider now employed by the care of critically ill paof the chest of nutrients. vessels for However, incidence life-threatenof

used to drain The use of chest was reported by postregularly

in postoperative

is a definite a potentially

in World War II, for acute trauma did the Korean
OF

emergency not become

tube thorcommon-

complication, thorax).Traditionally, mothorax thoracic of invasive individuals competent management. elective

pneumothorax (hemopneumotube thoracostomy for pneuhas been handled by because of the increased by such the pulmonologist, procedures should principles placement, for the use those be of the

CHARACTERISTICS

CHEST

TUBES

or hemothorax surgeon. Today, procedures performing in

Modern their earlierplastic markers, of

chest tubes counterparts. varying multiple internal drainage

are

distinctly They are diameter, holes, and

different from made of clear with distance a radiopaque

tube thoracostomy and In addition to emergency for tube thoracostomy

indications

stripe, which outlines the proximal drainage hole. This addition permits better determination of appropriate tubeposition on a postplacement chest roentgenogram. They are pliable but Tube not supple enough can vary to kink from 20 or obstruct drainage. diameter

pulmonologist include thoracoscopy and pleurodesis of a symptomatic malignant pleural effusion. The purpose of this paper was to (1) review the historic development of tube thoracostomy; nique ofinsertion, drainage systems, (2) discuss techandmanagement

to 40 French (5 to II mm internal diameter) for adults, 6 to 26 French (2 to 6 mm) for children. The proximal end is slightly bevelled and tubing.
FOR CHEST TUBES

flared

to allow

ease

of

ofchest tubes; (3) examine individual components and their optimal characteristics; and (4) note the spectrum and incidence of complications associated with the procedure.
HISTORIC...
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