Closed Tube Thoracostomy
If you or a loved one has been scheduled for a closed tube thoracostomy, you likely know it more commonly as "inserting a chest tube." While the name sounds technical, it is a vital, life-saving procedure used to clear the space around your lungs so you can breathe freely again.
In this guide, we’ll walk through why this procedure is necessary, how it works, and what the recovery process looks like.
What is a Closed Tube Thoracostomy?
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A closed tube thoracostomy is a procedure where a hollow plastic tube is inserted through the chest wall and into the pleural space (the area between the lung and the chest wall).
The term "closed" refers to the fact that the tube is connected to a one-way drainage system. This system allows air, blood, or fluid to leave the chest without letting any outside air leak back in, which helps the lung re-expand.
Why is a Chest Tube Necessary?
Your lungs need a vacuum-like environment to stay expanded. When something fills the pleural space, that vacuum is lost, and the lung may collapse. This procedure is commonly used to treat:
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Pneumothorax: A collapsed lung caused by air trapped in the chest.
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Pleural Effusion: Excess fluid surrounding the lung (often due to heart failure or pneumonia).
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Hemothorax: Blood in the chest cavity, usually following an injury or surgery.
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Empyema: An accumulation of pus due to a severe infection.
What Happens During the Procedure?
A tube thoracostomy can be performed in an emergency room, a surgical suite, or at the hospital bedside. Here is the typical process:
1. Preparation and Numbing
The medical team will clean the skin, usually on the side of the chest under the armpit. A local anesthetic is injected to numb the skin and the deeper tissues between the ribs. In non-emergency cases, you may also receive sedation to help you relax.
2. Insertion
The doctor makes a small incision (about 1–2 cm) and carefully creates a path between the ribs. The chest tube is then guided into the pleural space. You may feel some pressure or a "popping" sensation during this step.
3. Securing the Tube
Once the tube is in place, it is stitched to the skin to prevent it from moving and covered with a sterile dressing. The other end of the tube is connected to a drainage canister.
4. Confirmation
A chest X-ray is almost always taken immediately after the procedure to ensure the tube is in the perfect position and the lung is responding well.
Living with a Chest Tube
While the tube is in place, your medical team will monitor the drainage levels and your breathing.
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Movement: You can usually move around in bed and sometimes even walk with assistance, but you must keep the drainage canister lower than your chest at all times to allow gravity to help with drainage.
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Pain Management: It is normal to feel some discomfort while the tube is in. Your doctor will provide pain relief to ensure you can take deep breaths and cough comfortably.
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Deep Breathing: You will likely be asked to use an incentive spirometer to keep your lungs active and prevent pneumonia.
Removing the Chest Tube
The tube stays in until the air or fluid has stopped leaking and the lung remains fully expanded. This can take anywhere from a couple of days to a week.
Removing the tube is a quick process. Your doctor will ask you to take a deep breath and hold it (the Valsalva maneuver) while the tube is gently pulled out. The opening is then quickly sealed with a special bandage.
Summary
A closed tube thoracostomy is a highly effective way to treat serious lung conditions and restore normal breathing. While it may feel intimidating, it is a standard medical intervention designed to protect your respiratory health.
Are you experiencing sudden chest pain or severe shortness of breath? These can be signs of a collapsed lung. Seek emergency medical care immediately to determine if a chest tube or other intervention is required.
About the Service Provider
Dr. Smaran Cladius - MD Respiratory Medicine, Fellowship in Interventional Pulmonology, Certificate in Allergy Testing & Allergen Immunotherapy
Pulmonologist | Chest Physician | Allergy & Sleep Specialist
Dr. Smaran Cladius is a pulmonologist specializing in the diagnosis and management of respiratory diseases, including chronic cough, asthma, COPD, respiratory allergies, tuberculosis, interstitial lung diseases and sleep-related breathing disorders.
Medically reviewed and Last updated: July 2026
This information is for general educational purposes only and is not a substitute for professional medical advice. Read our full Medical Disclaimer →