PURPOSE: Chest tube patency is necessary for its proper functioning. Kinking of the chest tube is the most common cause of early failure of functioning. Chest radiographs are the standard method to detect a tube kink. It may not be quickly available. We describe a simple bedside test that can accurately assess chest tube patency.
METHODS: After placement of a large bore of 28 Fr or greater chest tube but prior to it being secured a 114 Fr Air Life (tm) suction catheter was passed through the chest tube lumen. If the catheter was easily able to traverse the entire chest tube, the tube was deemed patent. If resistance was encountered, the tube was deemed kinked. An immediate chest radiograph was obtained to assess for possible kinking and the results of the catheter patency test was correlated to the radiograph findings. The chest tube was secured after confirmation of patency.
RESULTS: Forty-five 28 Fr chest tubes were placed in our medical intensive care unit between January 1, 2009 and March 31, 2010. 44 tubes were placed to treat a severe pneumothorax and one was placed to drain an empyema. The suction catheter detected patency in 43 cases. This was confirmed by chest radiography in all cases. In 2 cases the catheter met resistance; kinking was confirmed by a chest radiograph. The chest tube was repositioned and subsequent patency was detected by catheter passage and confirmed radiographically. Thus the bedside passage of catheters through the chest tube achieved a 100% sensitivity and specificity compared with radiography.
CONCLUSION: Passing a catheter through a chest tube can accurately determine chest tube patency. Kinked chest tubes can quickly be identified and repositioned without need for radiographic confirmation.
CLINICAL IMPLICATIONS: Passing a catheter through a chest tube is a simple method of assessing chest tube patency at the bedside.
DISCLOSURE: Kishan Ramachandran, No Financial Disclosure Information; No Product/Research Disclosure Information