My doctor says I will have a chest tube after my open heart surgery. I’m confused by this, isn’t a chest tube used when someone has a problem breathing?
Answer: A chest tube is a large plastic tube that is inserted into the chest. They are inserted for a variety of reasons. One reason, as you mentioned, is to help the lung re-inflate when someone has a collapsed lung, or 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.
Chest tubes also can drain any fluid that may accumulate in the lungs, such as blood after an injury or pus. The chest tube is connected to a device called a pleurovac, which collects the drainage for measurement. A chest tube can also be connected to gentle suction, if needed, to help drain the fluid.
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.
Chest tubes are typically held in place by several sutures, and often cause more discomfort than the surgical site. Depending on the nature of the surgery, there may be as many as 4 chest tubes in place, but 2 to 3 is more 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 reason for the tubes to stay. They are easily removed, as the suture is removed and they are gently pulled from the body.
Sources: Chest Tube Insertion. National Institutes of Health. Accessed April, 2009. http://www.nlm.nih.gov/medlineplus/ency/article/002947.htm
