page_title: Chest tube
section_title: Characteristics
hierarchical_section_title: Chest tube / Device / Characteristics
caption_attribution_description: English: Chest tube drainage holes in a variety of chest tubes.
context_page_description: A chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air, fluid, or pus from the intrathoracic space. It is also known as a Bülau drain or an intercostal catheter.
  The concept of chest drainage was first advocated by Hippocrates when he described the treatment of empyema by means of incision, cautery, and insertion of metal tubes. However, the technique was not widely used until the influenza epidemic of 1918 to drain post-pneumonic empyema, which was first documented by Dr. C. Pope, on "Joel", a 22-month-old infant. The use of chest tubes in postoperative thoracic care was reported in 1922, and they were regularly used post-thoracotomy in World War II, though they were not routinely used for emergency tube thoracostomy following acute trauma until the Korean War.
context_section_description: Chest tubes are commonly made from clear plastics like PVC and soft silicone. Chest tubes are made in a range of sizes measured by their external diameter from 6 Fr to 40 Fr. Chest tubes, like most catheters, are measured in French catheter scale. For adults, 20 Fr to 40 Fr (6.7 to 13.3mm external diameter) are commonly used, and 6 Fr to 26 Fr for children. Conventional chest tubes feature multiple drainage fenestrations in the section of the tube which resides inside the patient, as well as distance markers along the length of the tube, and a radiopaque stripe which outlines the first drainage hole. Chest tubes are also provided in right angle, trocar, flared, and tapered configurations for different drainage needs. As well, some chest tubes are coated with heparin to help prevent thrombus formation, though the effect of this is disputed.
  Chest tube have an end hole (proximal, toward the patient) and a series of side holes.  The number of side holes is generally 6 on most chest tubes.  The length of tube that has side holes is the effective drainage length (EDL).  In chest tubes designed for pediatric heart surgery, the EDL is shorter, generally by only having 4 side holes.
  Channel style chest drains, also called Blake drains, are so-called silastic drains made of silicone and feature open flutes that reside inside the patient. Drainage is thought to be achieved by capillary action, allowing the fluids to travel through the open grooves into a closed cross section, which contains the fluid and allows it to be suctioned through the tube.  Though these chest tubes are more expensive than conventional ones, they are theoretically less painful.
caption: Chest tube drainage holes
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