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Complications of Chest Drain Insertion and Management

  • Jan VolmerigEmail author
Chapter

Abstract

Chest drains and pleural aspirations represent a colorful medical mosaic in which many variables are involved: experience and training of the proceduralist, the indication for the procedure, the type of procedure, the duration of treatment, the quality of the effusion, drain management, the setting in which the procedure is done, and the most important aspect- the patient.

Keywords

Chest Tube Intercostal Space Malignant Pleural Mesothelioma Subcutaneous Emphysema Chest Drain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Literature: Complications

  1. 1.
    Bae JM. Life threatening hemoperitoneum and liver injury as a result of chest tube thoracostomy. Clin Med Insights. Case reports 2001;8:15–7. PMC [article] PMCID: PMC4345926, PMID: 25780345. doi: 10.4137/CCRep.S23139.
  2. 2.
    Baird R, Al-Balushi Z, Wackett J, Bouchard S. Iatrogenic Horner syndrome after tube thoracostomy. J Pediatr Surg. 2009;44(10):2012–4. doi: 10.1016/j.jpedsurg.2009.05.022. PubMed [citation] PMID: 19853764.
  3. 3.
    Ball CG, Lord J, Laupland KB, Gmora S, Mulloy RH, Ng AK, Schieman C, Kirkpatrick AW. Chest tube complications: how well are we training our residents? Can J Surg. 2007;50(6):450–8. PubMed [citation] PMID: 18053373, PMCID: PMC2386217.Google Scholar
  4. 4.
    Barak M, Iaroshevski D, Ziser A. Rapid atrial fibrillation following tube thoracostomy insertion. Eur J Cardiothorac Surg. 2003;24(3):461–2. PubMed [citation] PMID: 12965324.Google Scholar
  5. 5.
    Brownlow HA, Edibam C. Systemic air embolism after intercostal chest drain insertion and positive pressure ventilation in chest trauma. Anaesth Intensive Care. 2002;30(5):660–4. PubMed [citation] PMID: 12413269.Google Scholar
  6. 6.
    Cameron EW, Mirvis SE, Shanmuganathan K, White CS, Miller BH. Computed tomography of malpositioned thoracostomy drains: a pictorial essay. Clin Radiol. 1997;52(3):187–93. Review. PubMed [citation] PMID: 9091252.Google Scholar
  7. 7.
    Cardozo S, Belgrave K. A shocking complication of a pneumothorax: chest tube-induced arrhythmias and review of the literature. Case Rep Cardiol. 2014;2014:681572. doi: 10.1155/2014/681572. Epub 2014 Jul 24. PubMed [citation] PMID: 25147742, PMCID: PMC4131458.
  8. 8.
    Chan L, Reilly KM, Henderson C, Kahn F, Salluzzo RF. Complication rates of tube thoracostomy. Am J Emerg Med. 1997;15(4):368–70. PubMed [citation] PMID: 9217527.Google Scholar
  9. 9.
    Chen YM, Wu MF, Lee PY, Su WJ, Perng RP. Necrotizing fasciitis: is it a fatal complication of tube thoracostomy? Report of three cases. Respir Med. 1992;86(3):249–51. No abstract available. PubMed [citation] PMID: 1620913.Google Scholar
  10. 10.
    Cho SR, Lee JS, Kim MS. New treatment method for reexpansion pulmonary edema: differential lung ventilation. Ann Thorac Surg. 2005;80(5):1933–4. PubMed [citation] PMID: 16242493.Google Scholar
  11. 11.
    Da Rocha RP, Vengjer A, Blanco A, de Carvalho PT, Mongon ML, Fernandes GJ. Size of the collateral intercostal artery in adults: anatomical considerations in relation to thoracocentesis and thoracoscopy. Surg Radiol Anat. 2002;24(1):23–6. PubMed [citation] PMID: 12197006.Google Scholar
  12. 12.
    DuBose J, Inaba K, Okoye O, Demetriades D, Scalea T, O’Connor J, Menaker J, Morales C, Shiflett T, Brown C, Copwood B, AAST Retained Hemothorax Study Group. Development of posttraumatic empyema in patients with retained hemothorax: results of a prospective, observational AAST study. J Trauma Acute Care Surg. 2012;73(3):752–7. PubMed [citation] PMID: 22929504.Google Scholar
  13. 13.
    Etoch SW, Bar-Natan MF, Miller FB, Richardson JD. Tube thoracostomy. Factors related to complications. Arch Surg. 1995;130(5):521–5; discussion 525–6. PubMed [citation] PMID: 7748091.Google Scholar
  14. 14.
    Feller-Kopman D, Berkowitz D, Boiselle P, Ernst A. Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg. 2007;84(5):1656–61. PubMed [citation] PMID: 17954079.Google Scholar
  15. 15.
    Goltz JP, Gorski A, Böhler J, Kickuth R, Hahn D, Ritter CO. Iatrogenic perforation of the left heart during placement of a chest drain. Diagn Interv Radiol. 2011;17(3):229–31. doi: 10.4261/1305-3825.DIR.3131-09.0. Epub 2010 Aug 3. PubMed [citation] PMID: 20683819.
  16. 16.
    Harris A, O’Driscoll BR, Turkington PM. Survey of major complications of intercostal chest drain insertion in the UK. Postgrad Med J. 2010;86(1012):68–72. doi: 10.1136/pgmj.2009.087759. PubMed [citation] PMID: 20145053.
  17. 17.
    Hassan WU, Keaney NP. Winging of the scapula: an unusual complication of chest tube placement. J Accid Emerg Med. 1995;12(2):156–7. PubMed [citation] PMID: 7582419, PMCID: PMC1342561.Google Scholar
  18. 18.
    Havelock T, Teoh R, Laws D, Gleeson F, BTS Pleural Disease Guideline Group. Pleural procedures and thoracic ultrasound: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl 2):ii61–76. doi: 10.1136/thx.2010.137026. No abstract available. PubMed [citation] PMID: 20696688.
  19. 19.
    Heifetz SA, Zeichner MB, Minkowitz S. Sudden death from ruptured intercostal artery aneurysm. A late complication of thoracotomy. Arch Surg. 1975;110(10):1253–4. No abstract available. PubMed [citation] PMID: 1191.Google Scholar
  20. 20.
    Hibbert B, Lim TW, Hibbert R, Green M, Gollob MH, Davis DR. Ventricular tachycardia following tube thoracotomy. Europace. 2010;12(10):1504–6. doi: 10.1093/europace/euq172. Epub 2010 Jun 4. PubMed [citation] PMID: 20525725.
  21. 21.
    Hsu SP, Wang HC, Huang IT, Chu KA, Chang HC. Tube thoracostomy-related necrotizing fasciitis: a case report. Kaohsiung J Med Sci. 2006;22(12):636–40. PubMed [citation] PMID: 17116626.Google Scholar
  22. 22.
    Iaci G, Castiglioni A, Fumero A, Carlino M, Margonato A, Alfieri O. Resolution of an acute cardiac ischemia after the removal of a surgical drain in mitral and tricuspid valve repair. Ann Thorac Surg. 2011;91(6):e94. doi: 10.1016/j.athoracsur.2011.03.018. No abstract available. PubMed [citation] PMID: 21619958.
  23. 23.
    Jeon EY, Cho YK, Yoon DY, Seo YL, Lim KJ, Yun EJ. Angiographic analysis of the lateral intercostal artery perforator of the posterior intercostal artery: anatomic variation and clinical significance. Diagn Interv Radiol. 2015;21(5):415–8. PMC [article] PMCID: PMC4557326, PMID: 26268302. doi: 10.5152/dir.2015.15096.
  24. 24.
    John M, Razi S, Sainathan S, Stavropoulos C. Is the trocar technique for tube thoracostomy safe in the current era? Interact Cardiovasc Thorac Surg. 2014;19(1):125–8. doi: 10.1093/icvts/ivu071. Epub 2014 Mar 19. Review. PubMed [citation] PMID: 24648468.
  25. 25.
    Jones PM, Hewer RD, Wolfenden HD, Thomas PS. Subcutaneous emphysema associated with chest tube drainage. Respirology. 2001;6(2):87–9. PubMed [citation] PMID: 11422886.Google Scholar
  26. 26.
    Karmy-Jones R, Holevar M, Sullivan RJ, Fleisig A, Jurkovich GJ. Residual hemothorax after chest tube placement correlates with increased risk of empyema following traumatic injury. Can Respir J. 2008;15(5):255–8. PubMed [citation] PMID: 18716687, PMCID: PMC2679547.Google Scholar
  27. 27.
    Kerger H, Blaettner T, Froehlich C, Ernst J, Frietsch T, Isselhorst C, Nguyen AK, Volz A, Fiedler F, Genzwuerker HV. Perforation of the left atrium by a chest tube in a patient with cardiomegaly: management of a rare, but life-threatening complication. Resuscitation. 2007;74(1):178–82. Epub 2007 Feb 14. PubMed [citation] PMID: 17303305.Google Scholar
  28. 28.
    Kim D, Lim SH, Seo PW. Iatrogenic perforation of the left ventricle during insertion of a chest drain. Korean J Thorac Cardiovasc Surg. 2013;46(3):223–5. doi: 10.5090/kjtcs.2013.46.3.223. Epub 2013 Jun 5. PubMed [citation] PMID: 23772413, PMCID: PMC3680611.
  29. 29.
    Kollef MH, Dothager DW. Reversible cardiogenic shock due to chest tube compression of the right ventricle. Chest. 1991;99(4):976–80. PubMed [citation] PMID: 2009805.Google Scholar
  30. 30.
    Kopec SE, Conlan AA, Irwin RS. Perforation of the right ventricle: a complication of blind placement of a chest tube into the postpneumonectomy space. Chest. 1998;114(4):1213–5. PubMed [citation] PMID: 9792599.Google Scholar
  31. 31.
    Landay M, Oliver Q, Estrera A, Friese R, Boonswang N, DiMaio JM. Lung penetration by thoracostomy tubes: imaging findings on CT. J Thorac Imaging. 2006;21(3):197–204.Google Scholar
  32. 32.
    Limsukon A, Yick D, Kamangar N. Chylothorax: a rare complication of tube thoracostomy. J Emerg Med. 2011;40(3):280–2. doi: 10.1016/j.jemermed.2007.12.023. Epub 2008 Aug 30. PubMed [citation] PMID: 18757158.
  33. 33.
    Maskell NA, Butland RJ, Pleural Diseases Group, Standards of Care Committee, British Thoracic Society. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax. 2003;58 Suppl 2:ii8–17. No abstract available. PubMed [citation] PMID: 12728146, PMCID: PMC1766019.Google Scholar
  34. 34.
    Maybauer MO, Geisser W, Wolff H, Maybauer DM. Incidence and outcome of tube thoracostomy positioning in trauma patients. Prehosp Emerg Care. 2012;16(2):237–41. doi: 10.3109/10903127.2011.615975. Epub 2011 Oct 3. PubMed [citation] PMID: 21967410.
  35. 35.
    Millikan JS, Moore EE, Steiner E, Aragon GE, Van Way CW 3rd. Complications of tube thoracostomy for acute trauma. Am J Surg. 1980;140(6):738–41. PubMed [citation] PMID: 7457693.Google Scholar
  36. 36.
    Muthuswamy P, Samuel J, Mizock B, Dunne P. Recurrent massive bleeding from an intercostal artery aneurysm through an empyema chest tube. Chest. 1993;104(2):637–9. PubMed [citation] PMID: 8339668.Google Scholar
  37. 37.
    Nahum E, Ben-Ari J, Schonfeld T, Horev G (2001) Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve. Pediatr Radiol 31:444–6; PMID: 11436893.Google Scholar
  38. 38.
    Paul AO, Kirchhoff C, Kay MV, Hiebl A, Koerner M, Braunstein VA, Mutschler W, Kanz KG. Malfunction of a Heimlich flutter valve causing tension pneumothorax: case report of a rare complication. Patient Saf Surg. 2010;4(1):8. doi: 10.1186/1754-9493-4-8. PubMed [citation] PMID: 20565768, PMCID: PMC2901307.
  39. 39.
    Remérand F, Luce V, Badachi Y, Lu Q, Bouhemad B, Rouby JJ. Incidence of chest tube malposition in the critically ill: a prospective computed tomography study. Anesthesiology. 2007;106(6):1112–9. PubMed [citation] PMID: 17525585.Google Scholar
  40. 40.
    Resnick DK. Delayed pulmonary perforation. A rare complication of tube thoracostomy. Chest. 1993;103(1):311–3. PubMed [citation] PMID: 8417916.Google Scholar
  41. 41.
    Rice DC, Agasthian T, Clay RP, Deschamps C. Silicone thorax: a complication of tube thoracostomy in the presence of mammary implants. Ann Thorac Surg. 1995;60(5):1417–9. Review. PubMed [citation] PMID: 8526644.Google Scholar
  42. 42.
    Salon JE. Reversible diaphragmatic eventration following chest tube thoracostomy. Ann Emerg Med. 1995;25(4):556–8. Review. PubMed [citation] PMID: 7710170.Google Scholar
  43. 43.
    Schmidt U, Stalp M, Gerich T, Blauth M, Maull KI, Tscherne H. Chest tube decompression of blunt chest injuries by physicians in the field: effectiveness and complications. J Trauma. 1998;44(1):98–101. PubMed [citation] PMID: 9464755.Google Scholar
  44. 44.
    Seki M, Yoda S. Unexpected massive hemorrhage following the removal of a pleural drainage tube. Intern Med. 2015;54(8):953–4. doi: 10.2169/internalmedicine.54.3719. Epub 2015 Apr 15. PubMed [citation] PMID: 25876579.
  45. 45.
    Shapira OM, Aldea GS, Kupferschmid J, Shemin RJ. Delayed perforation of the esophagus by a closed thoracostomy tube. Chest. 1993;104(6):1897–8. PubMed [citation] PMID: 8252980.Google Scholar
  46. 46.
    Shojaee S, Argento AC. Ultrasound-guided pleural access. Semin Respir Crit Care Med. 2014;35(6):693–705. doi: 10.1055/s-0034-1395794. Epub 2014 Dec 2. Review. PubMed [citation] PMID: 25463160.
  47. 47.
    Sulimovic S, Noyez L. Postoperative myocardial ischemia caused by compression of a coronary artery by chest tube. J Cardiovasc Surg (Torino). 2006;47(3):371–2. No abstract available. PubMed [citation] PMID: 16760877.Google Scholar
  48. 48.
    Sundaramurthy SR, Moshinsky RA, Smith JA. Non-operative management of tube thoracostomy induced pulmonary artery injury. Interact Cardiovasc Thorac Surg. 2009;9(4):759–60. doi: 10.1510/icvts.2009.209262. Epub 2009 Jul 31. PubMed [citation] PMID: 19648149.
  49. 49.
    Svedjeholm R, Håkanson E. Postoperative myocardial ischemia caused by chest tube compression of vein graft. Ann Thorac Surg. 1997;64(6):1806–8. PubMed [citation] PMID: 9436578.Google Scholar
  50. 50.
    Tait P, Waheed U, Bell S. Successful removal of malpositioned chest drain within the liver by embolization of the transhepatic track. Cardiovasc Intervent Radiol. 2009;32(4):825–7. doi: 10.1007/s00270-008-9461-y. Epub 2008 Oct 30. PubMed [citation] PMID: 18972157.
  51. 51.
    Waydhas C, Sauerland S. Pre-hospital pleural decompression and chest tube placement after blunt trauma: a systematic review. Resuscitation. 2007;72(1):11–25. Epub 2006 Nov 22. Review. PubMed [citation] PMID: 17118508.Google Scholar
  52. 52.
    Wraight WM, Tweedie DJ, Parkin IG. Neurovascular anatomy and variation in the fourth, fifth, and sixth intercostal spaces in the mid-axillary line: a cadaveric study in respect of chest drain insertion. Clin Anat. 2005;18(5):346–9. PubMed [citation] PMID: 15971216.Google Scholar
  53. 53.
    Yen CC, Yang YS, Liu KY. Aortic perforation caused by friction of a chest tube after coronary artery bypass surgery. Heart Surg Forum. 2010;13(3):E159–60. doi: 10.1532/HSF98.20091165. PubMed [citation] PMID: 20534415.
  54. 54.
    Yoneyama H, Arahata M, Temaru R, Ishizaka S, Minami S. Evaluation of the risk of intercostal artery laceration during thoracentesis in elderly patients by using 3D-CT angiography. Intern Med. 2010;49(4):289–92. Epub 2010 Feb 15. PubMed [citation] PMID: 20154433.Google Scholar
  55. 55.
    Ward EW, Hughes TE (1994) Sudden death following chest tube insertion: and unusual case pf vagus nerve irritation. J Trauma 36:258–259.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Klinik für ThoraxchirurgieEv. Krankenhausgemeinsxchaft Herne Castrop-Rauxel gGmbHHerneGermany

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