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An intrapleural chest tube is also known as a Bülau drain or an intercostal catheter (ICC), and can either be a thin, flexible silicone tube (known as a "pigtail" drain), or a larger, semi-rigid, fenestrated plastic tube, which often involves a flutter valve or underwater seal.
The simplest system that is sufficient for chest drainage is a one-chamber system. It uses either a Heber-drain or an active suction source and comprises a single collection canister. For active or passive air evacuation, a water seal component is attached. To ensure that all air is sucked out when using a Heber-drain, manual support might be ...
A thoracostomy is a small incision of the chest wall, [1] with maintenance of the opening for drainage. [2] It is most commonly used for the treatment of a pneumothorax.This is performed by physicians, paramedics, and nurses usually via needle thoracostomy or an incision into the chest wall with the insertion of a thoracostomy tube (chest tube) or with a hemostat and the provider's finger ...
The flap allows for 1) passive drainage of the pleural space and 2) negative pressure to develop in the thoracic cavity due to it being easier for air to escape than to enter the chest. The lung can then expand to the chest wall and seal the inner opening of the flap. [3] Other surgeons have subsequently proposed modifications to the procedure. [6]
In postural drainage, the patient's body is positioned so that the trachea is inclined downward and below the affected chest area. [9] The body is positioned so that secretions drain into sequentially larger bronchi. [5] Frames, tilt tables, and pillows may be used to support patients in these positions. [1] [6] Up to 12 postures may be used. [10]
Alternatively, drainage tubes are passed over the guidewire (as in chest drains or nephrostomies). After passing a sheath or tube, the guidewire is withdrawn. [1] An introducer sheath can be used to introduce catheters or other devices to perform endoluminal (inside the hollow organ) procedures, such as angioplasty.
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Approximately 15 to 40 percent of people require surgical drainage of the infected pleural space because of inadequate drainage due to clogging of the chest tube or loculated empyema. [19] Patients should thus be considered for surgery if they have ongoing signs of sepsis in association with a persistent pleural collection despite drainage and ...
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