Chest Tube

The pleural space normally contains only a small amount of lubricating fluid and maintains subatmospheric pressure that keeps the lung expanded against the chest wall. Air, blood, chyle, infected fluid, or a large effusion disrupts that relationship; the lung recoils inward, gas exchange falls, and respiratory work increases. A chest tube evacuates air or fluid so the lung can re-expand. Indications include spontaneous, traumatic, or tension pneumothorax; hemothorax; pleural effusion; chylothorax; cardiac tamponade; and postoperative drainage after thoracic or cardiac surgery. The tube treats the mechanical problem while the underlying cause—such as trauma, surgery, infection, or a persistent air leak—receives separate management. The water-seal chamber acts as a one-way trap. Air can leave the pleural space through the water, but the liquid column prevents atmospheric air from travelling back toward the patient. Suction may increase the rate of evacuation and support re-expansion, but it is applied and documented at the prescribed setting; more suction is not automatically safer or more effective.