Thoracic Drainage Catheters and Tubes: Chest Tube Types, Sizes and Connections

The main thoracic drainage catheter designs

Different types of chest drain are usually grouped by how they are placed and by their calibre. Large-bore tubes are inserted surgically or by blunt dissection and are chosen where thick fluid, blood or large air volumes are expected. Smaller-bore catheters are placed over a guidewire and are typically used for simpler collections.

A thoracic drainage catheter with a trocar has an inner stylet that helps pass the tube through the chest wall. Most departments restrict trocar use to defined situations and personnel according to their protocol, so the supplier should offer the designs your surgeons actually use.

Whatever the design, the catheter should arrive sterile, with clear labelling of size and lot number, in packaging that is easy to open in a hurry. Ask whether kits are offered in several sizes so that theatres and wards can stock a standard range without opening many different brands.

Seldinger chest drain and other insertion approaches

A Seldinger chest drain is placed using a guidewire: a needle gains access, a wire is passed, the track is dilated and the catheter is slid over the wire. It tends to be a small-bore system. The alternative is a surgical or blunt-dissection approach for larger tubes.

Choice of insertion approach is clinical and local protocol decides. From a procurement viewpoint the question is whether kits include everything required: catheter, guidewire, dilator, connector and fixation, and whether they are sterile and single-use.

Chest tube types and sizes: how calibre is expressed

Sizes are normally given in French (Fr) units, where one French equals one third of a millimetre of outer diameter. Smaller sizes suit low-viscosity air or fluid, and larger ones are selected for blood, pus or heavy air leaks. Length, hole pattern, radiopaque line and the material also differ between products.

Check these properties when comparing: material softness and kink resistance, the number and position of drainage holes, the radiopaque marker and depth markings, and the connector type. A very flexible tube may kink more easily, while a very stiff tube may be less comfortable for the patient.

• Calibre in Fr and length.
• Straight or curved, with or without trocar.
• Number and position of drainage holes.
• Radiopaque line and depth markings.
• Sterile single-use packaging and connector type.

Connecting the catheter to the drainage unit

The catheter connects to the drainage unit by tubing and a connector, and every joint is a potential leak. Check that the tubing diameter and connector fit both the catheter and the unit, and that the tubing is long enough for patient movement but short enough to avoid loops below the unit.

For active electronic drainage, confirm compatibility with the unit. The ATMOS S 201 Thorax is a portable unit with a four-chamber 2000 ml canister and a vacuum range of −5 to −100 mbar, and the supplier should confirm which tubing and connectors are recommended with it. The overall system is described in our thoracic drainage system guide, and equipment setting differences by condition in chest drainage clinical indications.

Fixation matters too: a secure suture or dressing and a strain-relief loop keep the tube from being pulled when the patient moves, and a spare connector should be available at the bedside.

Buying thoracic drainage supplies

Beckfinity supplies thoracic drainage units and can advise on the compatibility of connectors and tubing with your preferred catheters. Send your requirements through the contact page. Product registration should be confirmed with the relevant UAE authority.

Before ordering, collect the preferences of surgeons, intensivists and nurses and write them into one specification, so that purchasing does not end up with several incompatible catheter families.