Thoracostomy

Thoracostomy is a procedure to decompress the pneumothorax or to drain pleural effusion.. Chest Thoracostomy is a life-saving technique that is resorted to in trauma cases. The tube is inserted into the pleural cavity to drain fluid, pus, blood or air. It is conducted for patients suffering Emphysema (irreversible lung disease where breathing becomes increasingly difficult), Pneumothorax (accumulation of air in pleural space), Chylothorax (milky lymphatic fluid in pleural space), Hydrothorax (accumulation of water in pleural space) and Pleural effusion.

Non invasive ventilation is usually the first line of therapy to avoid the intubation procedure in less severe cases. A peak expiratory flow rate (PEFR) assessment often is an useful adjunct to the physical examination of the patient with COPD (Chronic Obstructive Pulmonary Disease - progressive air way obstruction arising out of inflammatory pulmonary conditions).

Intubation : A tube is inserted into the pleural space by a physician who is trained in the procedure. The location of the insertion depends on whether air or fluid has to be drained. The area is cleaned and numbed. The tube is inserted between the ribs and the patient usually lies on the side or half sits up with the arm raised. The insertion site and the patient position depend on whether air or fluid is being drained. The tube is connected to a cannister into which the fluid or air is drained through suction. Often the chest tube insertion is guided by ultrasound or X-ray. Some of the possible risks of the Thoracostomy include bruising and bleeding of the chest wall and bacterial infection. Pulmonary or diaphragmatic laceration might occur.