FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 357:e15 October 11, 2007 Number 15 Next

	Since this article has no abstract, below are the first 100 words from the narration of this Video in Clinical Medicine and its chapter headings.

 

Video Download Options PDF Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

View Video The insertion of a pleural chest tube is often done in a setting where immediate action is required. Nonetheless, adherence to sterility, analgesia, sound technique, and safety are always warranted. Indications The most common indications for chest-tube drainage are: Pneumothorax that is recurrent, persistent, under tension, or bilateral; any pneumothorax in a patient on positive-pressure ventilation; hemothorax; recurrent or symptomatic large pleural effusion; empyema; and chylothorax. Contraindications There are relative contraindications, mainly based on hematologic abnormalities such as bleeding diatheses or coagulopathy. Blood products or coagulation factors may need to be transfused in order to reduce the . . . . View Video Chapters: Overview Indications Contraindications Equipment Landmarking Anesthetizing Tissues Incision and Dissection Securing the Tube Pleural Drainage Systems Complications Removing the Tube

 
References

1. Miller KS, Sahn SA. Chest tubes: indications, technique, management and complications. Chest 1987;91:258-264. [Web of Science][Medline]
2. Laws D, Neville E, Duffy J. BTS guidelines for the insertion of a chest drain. Thorax 2003;58:Suppl 2:ii53-ii59. [Free Full Text]
3. Tang ATM, Velissaris TJ, Weeden DF. An evidence-based approach to drainage of the pleural cavity: evaluation of best practice. J Eval Clin Pract 2002;8:333-340. [CrossRef][Web of Science][Medline]
4. Hyde J, Sykes T, Graham T. Reducing morbidity from chest drains. BMJ 1997;314:914-915. [Free Full Text]
5. Baumann MH. What size chest tube? What drainage system is ideal? And other chest tube management questions. Curr Opin Pulm Med 2003;9:276-281. [CrossRef][Web of Science][Medline]
6. Parulekar W, Di Primo G, Matzinger F, Dennie C, Bociek G. Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions. Chest 2001;120:19-25. [CrossRef][Web of Science][Medline]
7. Antunes G, Neville E, Duffy J, Ali N. BTS guidelines for the management of malignant pleural effusions. Thorax 2003;58:Suppl 2:ii29-ii38. [Free Full Text]
8. American Thoracic Society. Management of malignant pleural effusions. Am J Respir Crit Care Med 2000;162:1987-2001. [Free Full Text]
9. Light RW. Parapneumonic effusions and empyema. Proc Am Thorac Soc 2006;3:75-80. [Free Full Text]
10. Davies CWH, Gleeson FV, Davies RJO. BTS guidelines for the management of pleural infection. Thorax 2003;58:Suppl 2:ii18-ii28. [Free Full Text]
11. Baumann MH, Strange C, Heffner JE, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590-602. [CrossRef][Web of Science][Medline]

Related Letters:

Chest-Tube Insertion
Pinheiro J. M.B., Berrizbeitia L. D., Dev S. P., Simone C.
Extract | Full Text | PDF  
N Engl J Med 2008; 358:749-750, Feb 14, 2008. Correspondence

This article has been cited by other articles:

• Fowler, R. A., Adhikari, N. K. J., Scales, D. C., Lee, W. L., Rubenfeld, G. D. (2008). Update in Critical Care 2007. Am. J. Respir. Crit. Care Med. 177: 808-819 [Full Text]