Overview of the Spectrum of Chest Tubes with Focus on the Tunneled Pleural Catheter: Disease-Specific Selection

Abstract

Chest tube placement has been a long-standing therapeutic intervention in the setting of pneumothorax, empyema, and hemothorax. Competency in placement is required by surgeons, intensivists, pulmonologists, emergency room physicians, and radiologists.

There is a core set of medical knowledge and procedural technique that must be understood by the physician placing a chest tube. Over the past decade, there is an ongoing evolution of tube sizes available along with variation in technique that allows for improved patient comfort while providing optimal management of the pleural disease warranting chest tube placement. This chapter will review the approach to the patient with specific pleural diseases requiring chest tube placement. The indications, contraindications, spectrum of tubes available, basic technique, and management will be discussed with a focus on the indwelling pleural catheter. Review of the existing literature regarding optimal chest tube size for disease-specific pleural diseases will be included.