Thoracic Drainage | Chest

Thoracic Drainage

Thoracic drainage is a tube system that is connected to special bottles with or without suction function.Chest drainage is required to relieve the chest when air has entered the gap between the pleura and the lung. This clinical picture is called pneumothorax. The air that has penetrated leads to the lifting of the normally existing vacuum in the pleural gap, so that the lung collapses on the affected side.

The vacuum is essential for the lungs to be able to unfold properly, so it is imperative that the air be evacuated and the vacuum restored. This is especially true for the so-called tension pneumothorax, in which more and more air enters the pleural gap but cannot escape due to a valve mechanism. After some time, this leads to complete compression of the lung on the corresponding side and, as a consequence, to the displacement of the mediastinum with heart, esophagus and trachea to the opposite side.

This can become life-threatening within a very short time. The drainage tube is usually inserted into the pleural gap through a small skin incision. It is usually located either in the so-called Monaldi position in the second to third intercostal space approximately at the level of the middle of the collarbone (medioclavicular) or in the so-called Bülau position in the third to fifth intercostal space at the level of the anterior axillary fold.

Depending on the drainage system, a vacuum is now created by a pump, which draws the air out of the pleural gap and allows the lung to unfold again. Fluid accumulations can also be suctioned out via the thoracic drainage system. Accordingly, it can be used not only to relieve a pneumothorax, but also for pleural effusions, as well as blood and lymph fluid accumulations (hemato- and chylothorax) in the pleural gap.