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Comprehensive Review of Chest Tube ManagementA Review

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Abstract

Importance  Thoracostomy, or chest tube placement, is used in a variety of clinical indications and can be lifesaving in certain circumstances. There have been developments and modifications to thoracostomy tubes, or chest tubes, over time, but they continue to be a staple in the thoracic surgeon’s toolbox as well as adjacent specialties in medicine. This review will provide the nonexpert clinician a comprehensive understanding of the types of chest tubes, indications for their effective use, and key management details for ideal patient outcomes.

Observations  This review describes the types of chest tubes, indications for use, techniques for placement, common anatomical landmarks that are encountered with placement and management, and an overview of complications that may arise with tube thoracostomy. In addition, the future direction of chest tubes is explored, as well as the management of chest tubes during the COVID-19 pandemic.

Conclusions and Relevance  Chest tube management is subjective, but the compilation of data can inform best practices and safe application to successfully manage the pleural space and ameliorate acquired pleural space disease.

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Article Information

Accepted for Publication: October 22, 2021.

Published Online: January 26, 2022. doi:10.1001/jamasurg.2021.7050

Corresponding Author: David T. Cooke, MD, University of California, Davis Health, 2335 Stockton Blvd, North Addition Office Building, Ste 6121, Sacramento, CA 95817-2214 (dtcooke@ucdavis.edu).

Conflict of Interest Disclosures: Dr Brown reported grants from National Institutes of Health during the conduct of the study. No other disclosures were reported.

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