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Chest Drain complications

Complications Related to Chest Drain

A chest drain is a flexible plastic tube, is inserted through the chest wall into the pleural space or mediastinum through the doctor

Chest surgeries causes a pneumothorax on the operated side. During a thoracotomy the parietal pleura is incised and the pleural space is entered. Atmospheric air enters the pleural space, changing the normally negative pressure is that pleural space to a positive pressure. As a result, the lung recoils to its unexpanded size and remains collapsed.

Chest tubes are usually inserted in an operating room during chest surgerr. However, in some emergencies, a chest tube may be inserted in a treatment room or at the bedside.

Tension pneumothorax

Tension Pneumothorax caused by inter-pleural pressure exceeding atmospheric which can result from incorrect attachment of  water seal or a suction tube from the suction limb of drain collection unit to the wall suction but suction not being switched on. This would  make this a closed circuit, and in the presence of air, this can cause tension pneumothorax

Bleeding

Bleeding around the site and excessive drain loss. This can caused blood vessel damage at the time of insertion of chest drainage tube, so Chest x-ray and ultrasound may be required.  This would also require pressure dressing, fluid resuscitation and clotting screen to be sent

Subcutaneous emphysema

Subcutaneous emphysema occur after initial period if drainage holes migrate to outside pleural space or if the drain tube is to be blocked or kinked. Immediate inform doctor as this would require change in position of drain tube or another insertion

Infection

Infection occur at any time while the drain is inserted. Observe and monitor for clinical signs of infection such as pyrexia

Displacement

Displacement of chest drainage tube can occur at any time

Other Complications

  • Kinking
  • occlusion
  • Retrograde flow of fluid may occur if the collection chamber is raised above the  client level
  • Tension pneumothorax
  • Glass bottles can break