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  • drgoelmanoj@yahoo.co.in
Dr. Manoj K Goel
Director & Head
Dept of Pulmonology, Critical Care & Sleep Medicine
Fortis Memorial Research Institute,Gurugram(Delhi & NCR)

Details of procedure :

The site of intercostal tube placement is first localised clinicoradiologically or with the help of USG if required.   Antiseptic dressing and draping are done and local anaethesia is given in  and around the area of ICD placement. A small incision is made in the skin  followed by intercostal muscle separation is done to reach to the pleural space. Through this small hole in the chest, the tube is guided and introduced  into the pleural space. The ICD is connected to a appropriate drainage bag.  The chest tube is kept in place for the duration it is required which varies amongst the patients.

Possible risks and complications:

The incidence of major and minor complications associated with ICD are 1.9% and 5.5%, respectively.  The complications include improper placement, tube dislodgement, coughing, shoulder pain,  prolonged air leak, hemorrhage, subcutaneous emphysema, postoperative fever, empyema, wound infection, cardiac arrhythmias, reexpansion pulmonary edema, hypotension, seeding of chest wall in patients with mesothelioma, diaphragmatic tear and injury to surrounding organs.  There may be need for thoracotomy and additional procedures.  The mortality rate associated with ICD performed is 0.09%.   

 

Post procedure course: 

 

1) ) Postoperative oxygen supplementation may be required in some patients, particularly those with impaired lung function and those who have been sedated.

2) A chest radiograph is carried out post procedure

3) Patients should observe for  pain, breathlessness, haemoptysis, surgical emphysema and excessive coughing.

 

 

   

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