What Is a Pneumothorax Catheter?

A. Reed

The pneumothorax catheter is a type of transparent, pliable chest tube introduced into the thoracic cavity for the purpose of releasing trapped air, or to allow drainage of fluid so that the lungs can properly expand. Placement of a chest tube of this type is typically indicated for a collapsed lung via a procedure referred to as tube thoracosotomy, also called a chest tube drain. Certain complications are frequently experienced as a result of tube thoracosotomy.

The pneumothorax catheter can allow doctors to expel air or liquid from the thoracic cavity.
The pneumothorax catheter can allow doctors to expel air or liquid from the thoracic cavity.

Each lung is enclosed by a dual covering called the pleural membrane. That which covers the lung's exterior is referred to as the parietal pleura and is continuous with the pleural cavity. Visceral pleura is the membrane directly surrounding the lungs. The small area residing between these two membranes is what is known as the pleural space, inside of which fluid keeps the pleura moistened to prevent abrasion, as the lungs move and expand across the chest wall. The heart is housed between each of the right and left lungs.

Characterized by breathing difficulty, sharp chest pain, and tiredness, pneumothorax happens when air or other fluids such as pus and blood enter into the pleural space and becomes trapped inside the chest cavity. Due to pressure upon the lungs, a portion or complete deflation of the affected lung occurs, preventing continued extension and intake of oxygen. A sizable pneumothorax can also exert significant pressure and stress on the heart, causing subsequent heart failure. Pneumothorax occurs as a result of traumatic injury like a gun shot wound, lung surgery, or a medical condition such as asthma or chronic obstructive pulmonary disease (COPD). Although the condition is capable of healing by itself, sometimes placement of a pneumothorax catheter is necessary, especially when the pneumothorax is large.

Tube thoracosotomy involves insertion of a pneumothorax catheter through the chest wall into the thoracic cavity, and finally into the pleural space. For this procedure, it is generally recommended that it be performed after the patient has been administered a sedative and local anesthetic, allowing adequate timing for the agents to take effect. The patient should remain fully conscious to prevent respiratory depression or decreased heart functioning. Introduction of the pneumothorax catheter is performed as it is guided into an incision made within an area just below the arm pit while the patient's arm is flexed to expose this region. Positioning aids in proper placement of the tube into the relevant intercostal space.

There are complications that can result from a chest drain procedure, namely infection, injury of the liver, or errors in tube placement. Even though accurately situated, the pneumothorax catheter can still become dislodged or jammed, requiring it to be reinserted. Most complications with this procedure are minimal, but they do commonly occur.

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