Percutaneous Dilational Thoracostomy Catheter and Heimlich Valve Placement

Abstract

Percutaneous thoracostomy catheters can be used for both short- and long-term drainage.A pigtail catheter is a good choice for prolonged pleural drainage, while straight catheters are best for short-term drainage.Heimlich valves are one-way valves that allow drainage of fluid or air from the pleural cavity upon expiration without allowing air to reenter on inspiration.The Heimlich valve can replace pleurovac drainage systems in select patients and can allow for more mobility.The Heimlich valve works best for air and simple fluid. Blood or thick purulent fluid can cause malfunction of the valve system.For a pneumothorax, the catheter can be placed either in the midclavicular line in the second or third intercostal space or in the midaxillary line in the fourth or fifth intercostal space.For a pleural effusion, the catheter should be placed in the midaxillary line in the fourth or fifth intercostal space.