Q: 32 year old male is admitted to ICU after an episode of spontaneous pneumothorax (PTX). CXR normalized after insertion of chest tube. What is the danger of putting chest tube to a water seal device with suction?
Answer: re-expansion pulmonary edema
Chest tube in patients with pneumothorax usually put connected to a water seal device. Application of suction should be applied only if there is no resolution of PTX, as there is a risk of re-expansion pulmonary edema.
MacDuff A, Arnold A, Harvey J, BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65 Suppl 2:ii18.