THORACOSTOMY TUBES .2. PLACEMENT AND MAINTENANCE

Part I of this two-part presentation, which was published in the Novem ber 1997 issue, discussed how a thoracostomy tube works, when a thorac ostomy tube is appropriate, how to select a tuber and how to anestheti ze the patient before placement. This part discusses open and closed p lacement techniques and tube maintenance. Open insertion, which is per formed during thoracotomy, allows the surgeon to place the tube safely under direct visualization, Closed placement is more difficult; sever al techniques are described, Problems associated with thoracostomy tub es can be lethal; therefore, proper management is crucial. Intermitten t aspiration or continuous suction can be used to remove air and fluid . The veterinarian must avoid exerting too much negative pressure duri ng aspiration. Thoracic radiographs are taken both after the tube has been inserted and an initial aspiration performed and before the tube is removed. The tubes removed when the amount of air or fluid being re moved is no longer significant.