The pleural space normally contains a thin layer of lubricating fluid that allows the visceral and parietal pleura to move without friction during respiration. An excess of fluid, air, or both in this space alters intrapleural pressure and causes partial or complete lung collapse. A chest tube allows drainage of the air or fluid from the pleural space and enables lung reexpansion and the restoration of negative pressure to the pleural space.¹

After the patient’s lung has reexpanded and any drainage has been controlled, the doctor may order a chest tube to be clamped or have suction discontinued, with the tube left to water-seal drainage for several hours before removal to assess the patient’s tolerance. This waiting period allows time to observe the patient for signs and symptoms of respiratory distress, an indication that air or fluid remains trapped in the pleural space. The doctor may also order a chest X-ray before removal.

A chest tube is usually removed within 7 days of insertion to prevent infection along the tube tract.¹ Chest tube removal is the responsibility of the doctor, nurse practitioner, advance practice nurse, or physician’s assistant, according to scope of practice.