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2007, Number 2

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Cir Gen 2007; 29 (2)

End to the discussion on how to remove a pleural tube based on a simple chest model

Contreras-Ruiz VR, Rojas-Díaz O, Vidal-González P, Sánchez-Jureidini GO, González-Avilés JM
Full text How to cite this article

Language: Spanish
References: 7
Page: 136-139
PDF size: 116.30 Kb.


Key words:

Chest tube, chest tube removal, pleural cavity, thoracostomy.

ABSTRACT

Objective: To describe a chest model and to demonstrate the right way to remove the pleural tube.
Setting: “ABC” Medical Center.
Design: Experimental model.
Material and methods: We describe a chest model constructed with materials readily available at any hospital, it is easy to manufacture (an empty plastic soda bottle (1.5 L), a condom, a piece of suture or a rubber band, a plastic hose of approximately 8 mm in diameter, in which holes have been made to simulate a pleural tube, and a disposable surgical glove).
Results: The different ways to remove the pleural tube and the model provides visible evidence of pleural physiology and how to remove correctly the tube demonstrating that in deep inspiration, and maneuver of Valsalva the pleural tube can be retired without a new pneumothorax.
Conclusions: The chest model is simple, and brings and end to doubts and discussions. The optimal way to remove the tube is during deep inspiration and with the Valsalva maneuver during which no recurring pneumothorax is originated in spite of not removing the tube quickly.


REFERENCES

  1. Davis JW, Mackersie RC, Hoyt DB, Garcia J. Randomized study of algorithms for discontinuing tube thoracostomy drainage. J Am Coll Surg 1994; 179(5): 553-7.

  2. Miller KS, Sahn SA. Chest tubes. Indications, technique, management and complications. Chest 1987; 91(2): 258-64.

  3. Maier HC. The pleura. En: Gibbon JH, Sabiston DC, Spencer FC, editors: Surgery of the chest. Philadelphia: Saunders 1969; 213.

  4. Schmidt GA. Special problems in ICU. En: Hall JB, Schmidt GA, Wood LD editors. Principles of critical care. 2nd Ed. New York: Mc Graw-Hill, 1998; 1468.

  5. Abel JG, Ali J. Tube thoracostomy and pleurodesis. En: Hall JB, Schmidt GA, Wood LD. Principles of critical care. New York: Mc Graw-Hill, 1992: 224-26.

  6. Le Brigand H. Editor. Tratado de técnica quirúrgica. Barcelona: Toray-Masson, 1975. Tomo III Pp 67-77.

  7. Bell RL, Ovadia P, Abdullah F, Spector S, Rabinovici R. Chest tube removal: end-inspiration or end-expiration? J Trauma 2001; 50(4): 674-7.




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Cir Gen. 2007;29