Intercostal Drainage in Pleural Diseases

A chest drain procedure (or pleural drain procedure) drains air, blood or fluid through a tube that is inserted into the space surrounding your lungs, called the pleural space.

Why do I need a chest drain?

Fluid or air can build up in the pleural space after surgery or when there is inflammation, infection or a traumatic injury to the lungs. Sometimes, air can build up quickly for no clear reason. This is known as a spontaneous pneumothorax.

You may need a chest drain if you have any of the following conditions:

• Bleeding around your lung due to recent trauma (eg car accident)
• Collapsed lung – called a pneumothorax
• Fluid build up due to a condition such as cancer or pneumonia - called a pleural effusion
• Fungal infection.

You may also need a chest drain before or after lung surgery.

What happens during a chest drain procedure?

During a chest drain procedure:

• You will be lying on a bed, slightly up and to the side, with one arm raised above your head (sometimes you may be positioned sitting upright and leaning forward)
• Your doctor will clean the area where the tube will be inserted
• You will be given a local anaesthetic to numb the area
• The doctor will make a small cut between the ribs. The cut is usually made between the 5th and 6th rib - in line with the nipple, and slightly in front of the armpit on the affected side
• The doctor will then, very gently, guide a plastic tube into the pleural space
• The doctor may apply a stitch and dressing to keep the tube in place
• The tube will be attached to a one-way drainage system that only allows air and fluid to flow out from the pleural space to help expand your lung
• When all excess fluid or air is drained from the pleural space, and the lung is fully expanded, the tube can be removed.

The chest tube usually stays in for a few days – during this time, you will remain in the hospital. Sometimes your drain will be attached to suction on the wall which may limit your movement away from your bed.