Getting a Chest Tube for Surgery

If you're having open heart surgery, there is a chance your healthcare providers will say you will need a chest tube after surgery. This may confuse some patients, as many people associate the need for a chest tube with breathing problems. 

A chest tube is a large plastic tube that is inserted into the chest through a small hole that goes between the ribs and into the chest cavity.

Why a Chest Tube Is Placed

A chest tube is placed for a variety of reasons. One reason is to help the lung re-inflate when someone has a collapsed lung, also known as a pneumothorax. In that circumstance, a chest tube is inserted along the side of the ribs to allow the lung to reinflate. An incision is made between the ribs and the tube is pushed into the chest until it rests along the lung. The process can be quite painful, so the area is numbed prior to the insertion whenever possible.

Individuals who have a collapsed lung would typically have one placed per lung, as that is usually adequate to get the lung to reinflate. 

Chest tubes drain fluid in the space between the lung and the chest wall. The chest tube is connected to a device called a pleurovac, which collects the drainage for measurement and may be connected to gentle suction, if needed, to help drain the fluid.

Chest Tubes After Open Heart Surgery

When a patient has a chest tube after heart surgery, the tube is inserted near the sternum (breastbone) and is intended to drain any blood that accumulates away from the surgery site. This is especially important because the heart is surrounded by a tissue sac, called the pericardium, which can interfere with the function of the heart if it becomes full of fluid. The chest tube insertion is done during surgery and under anesthesia, so there is no pain from the process.

Life With a Chest Tube

Here is the good news: Chest tubes do not typically stay in place more than a few days, which is positive because they can cause quite a lot of discomfort.

Chest tubes are typically held in place by several sutures, and often cause more discomfort than the surgical incision itself, if it was placed during surgery. Depending on the nature of the surgery, there may be as many as four chest tubes in place, but two to three is typical.

The tubes are typically removed within 48 to 72 hours after open heart surgery unless there is more drainage than is typical, or the surgeon determines that there is a reason for the tubes to stay. They are easily removed, as the suture is removed and they are gently pulled from the body.

Chest tubes that are placed to drain fluid including pus or blood may remain in place until the drainage stops, but that is rarely more than three to four days, and tubes that are placed to inflate a lung after pneumothorax can typically be removed a day or two after the lung is inflated.