Version 1
: Received: 25 September 2024 / Approved: 27 September 2024 / Online: 27 September 2024 (11:03:37 CEST)
How to cite:
Sorino, C.; Feller-Kopman, D.; Mei, F.; Mondoni, M.; Agati, S.; Marchetti, G.; Rahman, N. M. Chest Tube and Pleural Drainage: History and Current Status in Pleural Diseases Management. Preprints2024, 2024092194. https://doi.org/10.20944/preprints202409.2194.v1
Sorino, C.; Feller-Kopman, D.; Mei, F.; Mondoni, M.; Agati, S.; Marchetti, G.; Rahman, N. M. Chest Tube and Pleural Drainage: History and Current Status in Pleural Diseases Management. Preprints 2024, 2024092194. https://doi.org/10.20944/preprints202409.2194.v1
Sorino, C.; Feller-Kopman, D.; Mei, F.; Mondoni, M.; Agati, S.; Marchetti, G.; Rahman, N. M. Chest Tube and Pleural Drainage: History and Current Status in Pleural Diseases Management. Preprints2024, 2024092194. https://doi.org/10.20944/preprints202409.2194.v1
APA Style
Sorino, C., Feller-Kopman, D., Mei, F., Mondoni, M., Agati, S., Marchetti, G., & Rahman, N. M. (2024). Chest Tube and Pleural Drainage: History and Current Status in Pleural Diseases Management. Preprints. https://doi.org/10.20944/preprints202409.2194.v1
Chicago/Turabian Style
Sorino, C., Giampietro Marchetti and Najib M. Rahman. 2024 "Chest Tube and Pleural Drainage: History and Current Status in Pleural Diseases Management" Preprints. https://doi.org/10.20944/preprints202409.2194.v1
Abstract
Thoracostomy and chest tube placement are key procedures in treating various pleural diseases involving the accumulation of fluids (e.g. malignant effusions, serous, pus, or blood) or air (pneumothorax) in the pleural cavity.
Initially described by Hippocrates and refined through the centuries, chest drainage obtained historical milestones with the creation in the 19th century of closed drainage systems with methods to prevent the entry of air into the pleural space and to reduce infection risk. The introduction of plastic materials and the Heimlich valve further revolutionized chest tube design and function.
Technological advancements led to the availability of various chest tube designs (straight, angled, pig-tail) and drainage systems, including polyvinyl chloride (PVC) and silicone tubes with radiopaque stripes for better radiological visualization. Modern chest drainage units (CDUs) can incorporate smart digital systems that monitor and graphically report pleural pressure and evacuated fluid/air, improving patient outcomes. The application of suction, whether via wall systems or portable digital devices, enhances the efficacy of pleural drainage, although careful regulation is needed to avoid complications such as reexpansion pulmonary edema or prolongation of air-leak.
To prevent recurrent effusion, particularly due to malignancy, pleuroedsis agents can be applied through a chest tube into the pleural space. In other circumstances, such as non-expandable lung (NEL), maintaining a long-term chest drain may be the most appropriate approach and procedures such as placement of an indwelling pleural catheter (IPC) can significantly improve quality of life.
Continued innovations and rigorous training ensure that chest tube insertion remains a cornerstone of effective pleural disease management.
Medicine and Pharmacology, Pulmonary and Respiratory Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
